甲状旁腺病变的超声诊断价值及多种影像学对比分析
发布时间：2019-05-27 20:41
【摘要】：目的评价超声在甲状旁腺病变诊断中的价值，分析多种影像学技术在甲状旁腺疾病诊断中的对比研究结果。 方法回顾性分析了从2009年2月至2013年12月于我院行甲状旁腺手术切除患者94例，共104个病灶，术后病理结果为甲状旁腺腺瘤(parathyroid adenoma,PTA)85例，增生(parathyroid hyperplasia,PHPT)4例，腺癌(parathyroid carcinoma,PTC)3例，囊肿2例。患者全部行超声检查，行核素显像者84例，CT检查者45例，MRI检查者31例，本研究总结分析不同病变的声像图特征及血清甲状旁腺激素（parathyroidhormone，PTH）水平，分析误诊及漏诊原因，对多种影像学检查进行对比分析。 结果超声可以清晰显示甲状旁腺病变的大小、形态、部位、边界，内部回声、血流等情况,不同病变的声像图具有差异性，病变多发生于下极，多呈低回声，多为血流丰富，，甲状旁腺腺瘤随着体积的不断增大，易出现液化，甲状旁腺癌常伴有钙化，增生及腺癌患者血清甲状旁腺素水平增高更明显，超声对下极的病变更易显示。超声误诊及漏诊的原因主要有甲状腺后突结节、转移性淋巴结及异位的甲状旁腺。超声诊断的敏感性达82.7%，明显高于CT、MRI检查，对于直径小于1cm的病变，超声诊断的敏感性明显高于其他影像学检查单独使用，而对于合并甲状腺结节的病变，超声的敏感性低于核素显像及超声联合核素显像检查(P均0.05)。 结论超声诊断甲状旁腺病变的敏感性较高，可作为甲状旁腺功能亢进诊断的首选检查方法。对于异位的甲状旁腺病变及合并后凸甲状腺结节的病变，超声不容易发现及区分。联合运用多种影像学检查，同时结合血清PTH值及临床表现，可以提高病变诊断的敏感性，更好地进行术前定位和诊断。
[Abstract]:Objective to evaluate the value of ultrasound in the diagnosis of parathyroidosis and to analyze the comparative results of various imaging techniques in the diagnosis of parathyroidosis. Methods 94 patients (104 lesions) underwent parathyroidectomy from February 2009 to December 2013 were analyzed retrospectively. the postoperative pathological results were parathyroadenoma (parathyroid adenoma,PTA) in 85 cases and hyperplasia (parathyroid hyperplasia,PHPT) in 4 cases. There were 3 cases of parathyroid carcinoma,PTC and 2 cases of cyst. All the patients were examined by ultrasound, 84 cases were examined by radionuclide imaging, 45 cases by CT and 31 cases by MRI. The sonographic features of different lesions and the level of serum parathyroid hormone (parathyroidhormone,PTH) were analyzed, and the causes of misdiagnosis and missed diagnosis were analyzed. A variety of imaging examinations were compared and analyzed. Results Ultrasound could clearly show the size, shape, location, boundary, internal echo, blood flow and so on of parathyroid lesions. The sonographic images of different lesions were different. Most of the lesions occurred in the lower pole, most of them were hypoechoic, and most of them were rich in blood flow. Parathyroid adenoma is prone to liquefaction with the increase of volume. Parathyroid carcinoma is often accompanied by calcification. The increase of serum parathyroxine level is more obvious in patients with hyperplasia and adenocarcinoma. Ultrasound is more easy to show the lesions of the lower pole. The main causes of misdiagnosis and missed diagnosis were posterior thyroid nodules, metastatic lymph nodes and ectopic parathyroid gland. The sensitivity of ultrasound in the diagnosis of thyroid nodules was 82.7%, which was significantly higher than that of CT,MRI. For lesions with diameters smaller than 1cm, the sensitivity of ultrasound was significantly higher than that of other imaging examinations alone, but for lesions complicated with thyroid nodules. The sensitivity of ultrasound was lower than that of radionuclide imaging and ultrasound combined radionuclide imaging (P 0.05). Conclusion Ultrasound is sensitive in the diagnosis of parathyroathyropathy and can be used as the first choice for the diagnosis of hyperparathyropathy. It is not easy to detect and distinguish ectopic parathyroidosis and kyphotic thyroid nodules. Combined with various imaging examinations, combined with serum PTH value and clinical manifestations, the sensitivity of pathological diagnosis can be improved, and preoperative localization and diagnosis can be better carried out.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.1;R582
本文编号：2486465
[Abstract]:Objective to evaluate the value of ultrasound in the diagnosis of parathyroidosis and to analyze the comparative results of various imaging techniques in the diagnosis of parathyroidosis. Methods 94 patients (104 lesions) underwent parathyroidectomy from February 2009 to December 2013 were analyzed retrospectively. the postoperative pathological results were parathyroadenoma (parathyroid adenoma,PTA) in 85 cases and hyperplasia (parathyroid hyperplasia,PHPT) in 4 cases. There were 3 cases of parathyroid carcinoma,PTC and 2 cases of cyst. All the patients were examined by ultrasound, 84 cases were examined by radionuclide imaging, 45 cases by CT and 31 cases by MRI. The sonographic features of different lesions and the level of serum parathyroid hormone (parathyroidhormone,PTH) were analyzed, and the causes of misdiagnosis and missed diagnosis were analyzed. A variety of imaging examinations were compared and analyzed. Results Ultrasound could clearly show the size, shape, location, boundary, internal echo, blood flow and so on of parathyroid lesions. The sonographic images of different lesions were different. Most of the lesions occurred in the lower pole, most of them were hypoechoic, and most of them were rich in blood flow. Parathyroid adenoma is prone to liquefaction with the increase of volume. Parathyroid carcinoma is often accompanied by calcification. The increase of serum parathyroxine level is more obvious in patients with hyperplasia and adenocarcinoma. Ultrasound is more easy to show the lesions of the lower pole. The main causes of misdiagnosis and missed diagnosis were posterior thyroid nodules, metastatic lymph nodes and ectopic parathyroid gland. The sensitivity of ultrasound in the diagnosis of thyroid nodules was 82.7%, which was significantly higher than that of CT,MRI. For lesions with diameters smaller than 1cm, the sensitivity of ultrasound was significantly higher than that of other imaging examinations alone, but for lesions complicated with thyroid nodules. The sensitivity of ultrasound was lower than that of radionuclide imaging and ultrasound combined radionuclide imaging (P 0.05). Conclusion Ultrasound is sensitive in the diagnosis of parathyroathyropathy and can be used as the first choice for the diagnosis of hyperparathyropathy. It is not easy to detect and distinguish ectopic parathyroidosis and kyphotic thyroid nodules. Combined with various imaging examinations, combined with serum PTH value and clinical manifestations, the sensitivity of pathological diagnosis can be improved, and preoperative localization and diagnosis can be better carried out.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.1;R582
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相关期刊论文 前3条
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本文编号：2486465
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