原发性甲状旁腺肿瘤的超声与临床特征研究

Study on the ultrasound and clinical characteristics of primary parathyroid tumors

目的:分析甲状旁腺肿瘤病人临床特点和超声图像特点,为甲状旁腺肿瘤诊断和鉴别诊断提供参考。方法:回顾性分析经手术治疗的甲状旁腺肿瘤病人80例临床资料,其中甲状旁腺腺瘤69例(腺瘤组),甲状旁腺癌4例(癌组),甲状旁腺囊肿7例(囊肿组)。结果:腺瘤组病人以肾结石(9/69,13.04%)为主要临床表现。腺瘤组和癌组病人血磷水平均低囊肿组(P<0.05),腺瘤组病人血钙和碱性磷酸酶水平均高于囊肿组(P<0.05)。不同类型甲状旁腺肿瘤病人超声定位准确率差异有统计学意义(P<0.01),以腺瘤组最高,为79.71%(55/69)。不同类型甲状旁腺肿瘤病人肿瘤上下径、左右径、前后径间差异均有统计学意义(P<0.01),其中腺瘤组和癌组病人上下径、前后径和左右径均小于囊肿组(P<0.05)。甲状旁腺腺瘤组病人误诊14例,以结节性甲状腺肿(5例)和甲状腺腺瘤(5例)最为常见。结论:甲状旁腺腺瘤诊断时应综合考虑其临床表现、血磷和碱性磷酸酶等实验室检查相关指标,并结合超声声像图特点,必要时还需要联合^(99)Tcm-MIBI检查。

Objective:To analyze the clinical features and ultrasonographic features of patients with parathyroid tumors,and provide the reference for the diagnosis and differential diagnosis of parathyroid tumors.Methods:The clinical data of 80 patients with parathyroid tumor treated with operation were retrospectively analyzed,The patients were divided into the adenoma group(69 cases with parathyroid adenom),cancer group(4 cases with parathyroid carcinoma)and cyst group(7 cases with parathyroid cyst).Results:The kidney stones were the main clinical manifestations in adenoma group(9/69,13.04%).The serum phosphorus levels in cyst group were higher than that in adenoma group and cancer group(P<0.05),and the serum levels of alcium and alkaline phosphatase in adenoma group were higher than those in cyst group(P<0.05).The differences of the accuracy of ultrasound localization among patients with different types of parathyroid tumors were statistically significant(P<0.01),and which in adenoma was the highest[79.71%(55/69)].The differences of the vertical,transverse and anteroposterior diameters in patients with different types of parathyroid tumors were statistically significant(P<0.01),and the vertical,transverse and anteroposterior diameters in adenoma group and cancer group were less than those in cyst group(P<0.05).Fourteen patients in the parathyroid adenoma group were misdiagnosed,and the nodular goiter(5 cases)and thyroid adenoma(5 cases)were the most common.Conclusions:In the diagnosis of parathyroid adenoma,the clinical manifestations,blood phosphorus,ALP,other relevant indicators of laboratory examination and characteristics of ultrasonography should be taken into comprehensive consideration,,and the 99Tcm-MIBI examination should be combined when necessary.