全身骨显像发现继发性甲状旁腺功能亢进症致广泛转移性钙化1例

doi:10.3969/j.issn.1674-8115.2026.09.016

上海交通大学学报（医学版） ›› 2026, Vol. 46 ›› Issue (9): 1307-1312.doi: 10.3969/j.issn.1674-8115.2026.09.016

• 病例报告 • 上一篇

全身骨显像发现继发性甲状旁腺功能亢进症致广泛转移性钙化1例

盛矢薇(), 罗全勇

上海交通大学医学院附属第六人民医院核医学科，上海 200233

收稿日期:2026-02-12 接受日期:2026-03-26 出版日期:2026-09-09 发布日期:2026-09-09
通讯作者: 盛矢薇，主治医师，硕士；电子信箱：18930173715@163.com。

Whole-body bone scintigraphy reveals extensive metastatic calcification secondary to hyperparathyroidism: a case report

Sheng Shiwei(), Luo Quanyong

Department of Nuclear Medicine, Shanghai Sixth People′s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China

Received:2026-02-12 Accepted:2026-03-26 Online:2026-09-09 Published:2026-09-09
Contact: Sheng Shiwei, E-mail: 18930173715@163.com.

摘要/Abstract

摘要：

该文报道1例46岁男性患者，有6年慢性肾脏病5期病史，长期行腹膜透析治疗，因轻微摔伤后出现全身多处疼痛、活动受限就诊。实验室检查显示严重高磷血症（2.85 mmol/L）、低钙血症（2.04 mmol/L）及甲状旁腺激素显著升高（356 pg/mL）。全身骨显像联合单光子发射型计算机断层显像（single-photon emission computed tomography，SPECT）/CT检查显示：双侧肩关节、髋关节及耻骨联合周围软组织内广泛异常放射性浓聚，与CT显示的钙化团块精确匹配；同时可见典型的代谢性骨病征象及多处与外伤部位相符的急性骨折灶。该病例最终诊断为肾性骨营养不良合并广泛转移性钙化。该病例表明，全身骨显像联合SPECT/CT在慢性肾脏病患者的综合评估中具有重要价值，可作为一站式检查工具，同时检测软组织钙化、评估代谢性骨病类型及严重程度、发现隐匿性骨折，为临床诊疗决策提供全面依据。

关键词: 转移性钙化, 肾性骨营养不良, 继发性甲状旁腺功能亢进症, 骨显像

Abstract:

This paper reports one case of a 46-year-old male patient with a 6-year history of stage 5 chronic kidney disease who had been undergoing long-term peritoneal dialysis and was admitted for generalized pain and limited movement following a minor fall. Laboratory examinations revealed severe hyperphosphatemia (2.85 mmol/L), hypocalcemia (2.04 mmol/L), and markedly elevated parathyroid hormone levels (356 pg/mL). Whole-body bone scintigraphy combined with single-photon emission computed tomography (SPECT)/CT showed extensive abnormal radiotracer accumulation in the soft tissues around the bilateral shoulder joints, hip joints, and pubic symphysis, which precisely matched the calcified masses shown on CT. Typical signs of metabolic bone disease and multiple acute fractures corresponding to traumatic injury sites were also detected. The patient was finally diagnosed with renal osteodystrophy accompanied by extensive metastatic calcification. This case suggests that whole-body bone scintigraphy combined with SPECT/CT is of great value in the comprehensive evaluation of patients with chronic kidney disease. As a one-stop imaging examination, it can simultaneously detect soft tissue calcification, evaluate the type and severity of metabolic bone disease, identify occult fractures, and provide comprehensive evidence for clinical diagnosis and treatment.

Key words: metastatic calcification, renal osteodystrophy, secondary hyperparathyroidism, bone scintigraphy

中图分类号:

R582.1

盛矢薇, 罗全勇. 全身骨显像发现继发性甲状旁腺功能亢进症致广泛转移性钙化1例[J]. 上海交通大学学报（医学版）, 2026, 46(9): 1307-1312.

Sheng Shiwei, Luo Quanyong. Whole-body bone scintigraphy reveals extensive metastatic calcification secondary to hyperparathyroidism: a case report[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2026,(9): 1307-1312.

图/表 3

图1 肩关节CT图像Note： CT scan reveals multiple patchy high-density calcifications in the soft tissues surrounding the left shoulder joint (A) and the right shoulder joint (B).

Fig 1 CT images of shoulder joints

图2 全身骨显像平面图像Note： Whole-body bone scintigraphy shows increased radiotracer uptake in the soft tissues of the bilateral shoulders and left hip joint, diffusely elevated radiotracer uptake in the skull, widening of the mandible, and a characteristic “beaded” appearance of the bilateral ribs.

Fig 2 Planar whole-body bone scintigraphy

图3 双侧髋关节SPECT/CT融合图像Note： SPECT/CT fusion images showing exact spatial correlation between radiotracer uptake and calcified masses in the bilateral hip regions. The upper row (A‒D) corresponds to the left hip joint, and the lower row (E‒H) corresponds to the right hip joint. A/E. SPECT tomographic images of the hip joints. B/F. Soft-tissue window CT images of the hip joints. C/G. Bone-window CT images of the hip joints. D/H. SPECT/CT fused images of the hip joints.

Fig 3 SPECT/CT fusion images of the bilateral hip joints

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全身骨显像发现继发性甲状旁腺功能亢进症致广泛转移性钙化1例

Whole-body bone scintigraphy reveals extensive metastatic calcification secondary to hyperparathyroidism: a case report

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