超声对难治性继发性甲状旁腺功能亢进诊断价值

The diagnostic value of ultrasonography in refractory secondary hyperparathyroidism

目的探讨超声检查对难治性继发性甲状旁腺功能亢进(secondary hyperparathyroidism,SHPT)的应用价值。方法回顾性分析98例难治性SHPT患者,记录超声检出甲状旁腺的位置、数目与大小,分析其声像图特征,并与病理结果对照,计算甲状旁腺的误诊率、检出率、漏诊率。结果大部分难治性SHPT患者甲状旁腺异常回声区的超声特点为低回声(99.3%)、丰富血流(92.3%)、最大直径>10mm(86.3%)。超声检查的符合率为95.2%(300/315)、误诊率为4.8%(15/315)、检出率为81.1%(300/370)、漏诊率为18.9%(70/370)。甲状腺中部背侧的检出率65.7%(65/99)与上下部背侧的检出率87.3%(234/268)的差异性具有统计学意义(X^2=32.971,P=0.000)。结论超声检查对难治性SHPT患者甲状旁腺的检出率高,定位准确,可以作为术前定位的检查方式,为临床医生手术提供更加可靠的依据。

Objective To study the diagnostic value of ultrasonography in patients with refractory secondary hyperparathyroid- ism （SHPT）. Methods 98 patients with refractory SHPT underwent uhrasonography. The location and number were noted. Echoes of enlarged parathyroid were analyzed. We compared with pathology and calculated coincidence rate, misdiagnosis rate, relevance rate and omission diagnostic rate. Results Echoes of enlarged parathyroid are low level echo （99.3%）, affl-uent blood flow （92.3%）, maximum diameter larger than 10 mm （86.3%）. Coinci-dence rate is 95.2% （300/315） , misdiagnosis rate is 4.8% （15/315）, relevance rate is 81.1% （300/370） and omission diagnose rate is 18.9% （70/370）. Relevance rate of middle part of thyroid is 65.7% （65/99） and relevance rate of upper and subjacent part of thyroid is 87.3% （234/268）. The difference between them is significant （χ^2= 32. 971, P = 0. 000）. Conclusion Ultrasonography in patients with refractory SHPT can be a choice for parathyroid location before operation by virtue of its high relevance rate and accurate location, then it can give more dependable evidence to doctor.