超声对慢性肾功能衰竭继发甲状旁腺增生的诊断分析

Analysis of ultrasound in the diagnosis of parathyroid hyperplasia secondary to chronic renal failure

目的探讨超声对慢性肾功能衰竭导致甲状旁腺功能亢进症继发甲状旁腺增生的诊断价值。方法选取从2016年1月~2019年11月在香港大学深圳医院接受治疗的56例慢性肾功能不全继发甲状旁腺增生患者为研究对象进行回顾分析,56例均经手术病理证实甲状旁腺增生,均进行甲状旁腺超声检查,分析甲状旁腺增生的超声图像特征并以病理学作为金标准,统计分析超声检查方法的阳性符合率。结果甲状旁腺增生超声声像图表现呈大小不一的低回声、等至低回声病变,部分内部可见钙化,彩色多普勒血流显像(Color Doppler Flow Imaging,CDFI)显示部分血流稀少,部分可见较丰富条索状或树枝状血流信号,部分周边可见环状血流包绕。56例患者病理共诊断出增生腺体196个,超声检出阳性病例53例,检出病灶136个,符合病理有130个,超声检查对甲状旁腺亢进病例诊断阳性符合率为94.64%(53/56),检出增生病灶的阳性符合率为66.32%(130/196)。结论超声对甲状旁腺增生诊断有特定的声像图特征,可作为诊断的首选方法,达到较高水平的检出率。

Objective To explore the diagnostic value of ultrasound in the diagnosis of parathyroid hyperplasia secondary to hyperparathyroidism caused by chronic renal failure.Methods 56 patients with parathyroid hyperplasia secondary to chronic renal insufficiency who were treated in the University of Hong Kong-Shenzhen Hospital from January 2016 to November 2019 were retrospectively analyzed.56 cases of parathyroid hyperplasia were confirmed by intraoperative pathology.All underwent parathyroid ultrasonography.The ultrasound image characteristics of parathyroid hyperplasia were analyzed.The positive coincidence rate of ultrasound examination methods was statistically analyzed by using pathology as the gold standard.Results Ultrasound imaging of parathyroid hyperplasia showed hypoechoic lesions,isoechoic to hypoechoic lesions of various sizes.Calcification was visible in some parts,and color Doppler Flow Imaging(CDFI)showed rich cord or dendritic blood flow signals.In some cases periphery was surrounded by circular blood flow.A total of 196 pathologically diagnosed hyperplastic glands were found in 56 patients,53 cases were positive by ultrasound,and a total of 136 lesions were detected,of which 130 were consistent with pathology.The positive coincidence rate of ultrasound diagnosis of parathyroid hyperplasia cases was 94.64%(53/56),and the positive coincidence rate of detected lesions was 66.32%(130/196).Conclusion Ultrasonography has specific sonographic features for the diagnosis of parathyroid hyperplasia,and it can be used as the preferred method for diagnosis,with a higher level of detection rate.