高分辨力超声术前评估病变甲状旁腺的声像图特征

Ultrasonic features of parathyroid lesions evaluated by pre-operative high-resolution ultrasound

目的:探讨高分辨力超声术前评估甲状旁腺功能亢进患者的声像图表现。方法:回顾性分析45例临床诊断甲状旁腺功能亢进患者的甲状旁腺位置、数目、大小、内部回声、血流分布类型、血流Adler分级、术前PTH水平及其相关性。结果:术前超声检出病变甲状旁腺共86枚,术后病理诊断为甲状旁腺增生或腺瘤。病变甲状旁腺的总长径与患者术前PTH水平呈显著正相关(rs=0.849),长径≥1 cm甲状旁腺组内部呈低回声的例数、血流丰富程度均明显高于长径<1 cm甲状旁腺组(P<0.05),病变甲状旁腺不同长径组间的内部回声均匀性、血流分布类型无统计学差异(P>0.05)。结论:高分辨力超声术前评估病变甲状旁腺具有一定特征性表现,结合血清PTH可对指导外科手术方案的制定有较高临床意义。

Objective:To explore ultrasonic characteristics of pre-operation high-resolution ultrasound in assessment of parathyroid lesions.Methods:The location,number,size,internal echo,type of blood flow distribution,blood flow Adler’s grades,preoperative PTH level and their correlation of 45 patients with hyperparathyroidism were analyzed retrospectively.Results:A total of 86 parathyroid lesions was detected by preoperative ultrasonography,and postoperative pathologic diagnosis was parathyroid hyperplasia or adenoma.The total length of the parathyroid lesions was significantly positively correlated with the preoperative PTH level(rs=0.849).The number of internal hypoechoic and the blood flow abundance in the long diameter≥1 cm parathyroid gland group were significantly higher than those in the long diameter<1 cm parathyroid gland group(P<0.05).There was no statistical difference in internal homogeneous echo or type of blood flow distribution between different long diameter groups of parathyroid lesions(P>0.05).Conclusion:The diagnosis of parathyroid lesions using high-resolution ultrasound has certain features,combined with serum PTH has high clinical significance for guiding the surgical operation plan.