Department of Radiology, School of Medicine, Hacettepe University, Sıhhiye, 06100, Ankara, Turkey.
Department of Pathology, School of Medicine, Hacettepe University, Sıhhiye, 06100, Ankara, Turkey.
Jpn J Radiol. 2022 May;40(5):484-491. doi: 10.1007/s11604-021-01220-7. Epub 2021 Nov 23.
To assess polar vessel presence and enhancement 4DCT imaging and their relation with biochemical and histopathological features.
Patients with primary hyperparathyroidism and preoperative 4DCT imaging were screened retrospectively and those with histopathologically proven diagnosis of PA were included. Biochemical findings, densitometric measurements (HU HU, HU, HU, HU, HU) and CT of PA on 4DCT, presence of a polar vessel (PV), and histopathological features were recorded. Correlations between serum PTH, calcium levels and densitometric measurements of PA on 4DCT were investigated. Differences between subgroups created according to PV presence were also evaluated.
Thirty-nine patients were enrolled (F/M = 32/7, median age = 57, interquartile range = 50-62 years). In all patients, serum PTH levels positively correlated with CT (r = 0.398, p = 0.012) but negatively correlated with HU (r = - 0.366; p = 0.022), HU (r = - 0.452; p = 0.004) and HU (r = - 0.421; p = 0.008). In PV (-) PAs, PTH levels were positively correlated with CT (r = 0.608, p ≤ 0.002) and negatively with HU (r = - 0.449, p ≤ 0.028), HU (r = - 0.560, p = 0.004), HU (r = - 0.460, p = 0.024), and HU (r = - 0.539, p = 0.007). No correlation between PTH levels and densitometric measurements was found in PV (+) PAs. HU and HU were significantly higher in PV (+) PAs compared to PV (-) PAs (p = 0.021 and p = 0.033, respectively). Histopathologic features revealed no difference according to the presence of PV.
PTH levels might have an association with imaging findings of PAs, especially when categorized with respect to PV presence. PTH levels were negatively correlated with degree of enhancement in PV (-) PAs. Therefore, radiologists should be aware that in patients with high serum PTH levels and without a discernible PV, PA might be difficult to localize.
评估极性血管的存在和增强 4DCT 成像及其与生化和组织病理学特征的关系。
回顾性筛选出患有原发性甲状旁腺功能亢进症和术前 4DCT 成像的患者，并纳入经组织病理学证实为甲状旁腺瘤（PA）的患者。记录生化发现、密度测量值（HU、HU、HU、HU、HU）和 4DCT 上 PA 的 CT、极性血管（PV）的存在以及组织病理学特征。研究血清甲状旁腺激素（PTH）、钙水平与 4DCT 上 PA 密度测量值之间的相关性。还评估了根据 PV 存在情况创建的亚组之间的差异。
共纳入 39 例患者（F/M=32/7，中位年龄 57 岁，四分位间距 50-62 岁）。在所有患者中，血清 PTH 水平与 CT 呈正相关（r=0.398，p=0.012），但与 HU 呈负相关（r=-0.366，p=0.022），HU 呈负相关（r=-0.452，p=0.004）和 HU 呈负相关（r=-0.421，p=0.008）。在 PV（-）PA 中，PTH 水平与 CT 呈正相关（r=0.608，p≤0.002），与 HU 呈负相关（r=-0.449，p≤0.028），HU 呈负相关（r=-0.560，p=0.004），HU 呈负相关（r=-0.460，p=0.024），HU 呈负相关（r=-0.539，p=0.007）。在 PV（+）PA 中，未发现 PTH 水平与密度测量值之间存在相关性。与 PV（-）PA 相比，PV（+）PA 中的 HU 和 HU 明显更高（p=0.021 和 p=0.033）。组织病理学特征显示，PV 的存在与 PA 无差异。
PTH 水平可能与 PA 的影像学表现有关，尤其是当根据 PV 存在情况进行分类时。PV（-）PA 中 PTH 水平与增强程度呈负相关。因此，放射科医生应该意识到，在血清 PTH 水平较高且无明显 PV 的患者中，PA 可能难以定位。
