甲状旁腺腺瘤超声及螺旋CT影像特征比较研究

A comparative study of parathyroid adenoma ultrasound and spiral CT imaging features

目的探讨甲状旁腺腺瘤（PTA）的超声及螺旋CT表现,比较2种方法的诊断价值。方法 对40例经手术病理证实为PTA患者的超声及CT表现作回顾性分析。比较采用2种方法诊断的敏感度、准确性。结果 39例患者术前行超声检查,其中30例诊断为PTA,超声特征多为实性低回声,常起源于下甲状旁腺,20例PTA血液信号较丰富,而最长直径〉3 cm的囊性变或1～2 cm小结节血流分布稀疏;PTA的CT特征多为平扫低密度或软组织密度,增强呈中等强化,发生囊性变多呈不均匀强化并可见点状钙化。高频超声检查诊断灵敏度76.9%,准确度76.7%;螺旋CT检查诊断灵敏度78.8%,准确度71.8%,2种影像学疗法的灵敏度和准确度比较差异无统计学意义（P〉0.05）。2种影像学方法具有一致性（Kappa值=0.52）。结论超声及螺旋CT检查相结合有利于早期筛查甲状旁腺肿物,并对其位置及囊实性做出判断。

Objective To investigate ultrasound and CT findings of parathyroid adenoma（PTA）,comparing the diagnostic value of the two methods.Methods Ultrasound and CT findings were retrospectively analyzed in 40 patients with pathologically confirmed PTA.Sensitivity of the method used to compare the two kinds of diagnostic accuracy.Results 39 cases of preoperative ultrasound examination,30 patients were diagnosed as PTA,sonographic features mosdy solid hypoechoic,often originated in the lower parathyroid glands,19 cases of PTA rich blood flow signals,the longest diameter 〉3 cm or cystic nodules 1-2 cm blood sparse;CT features PTA mosdy unenhanced low density or soft tissue density,enhanced showed moderate enhancement,cystic degeneration occurs mosdy heterogeneous enhancement and visible punctate calcification.High-frequency ultrasound diagnostic with sensitivity of 76.9%,accuracy of 76.7%;spiral CT diagnostic sensitivity of 78.8%,71.8%of accuracy,sensitivity and accuracy differences between the two kinds of imaging methods showed no significance（P 〉0.05）.Two kinds of imaging methods consistency is good（Kappa value = 0.52）.Conclusion Ultrasound and spiral CT examination in favor of the combination of early screening parathyroid tumor,and make a judgment on its location and cystic.