术前超声在原发性甲状旁腺功能亢进症中的临床应用价值  

Clinical Value of Preoperative Ultrasound in Primary Hyperparathyroidism(PHPT)

作　　者：赵威[1] 尹莉[1] 卢瑞刚[1] 吕朝阳 魏伯俊[2] 郭瑞君[1] Zhao Wei;Yin Li;Lu Ruigang;Lü Zhaoyang;Wei Bojun;Guo Ruijun(Department of Ultrasound,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China;Department of Thyroid and Neck Surgery,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院超声医学科,北京市100020 [2]首都医科大学附属北京朝阳医院甲状腺颈部外科,北京市100020

出　　处：《中国超声医学杂志》2021年第7期745-748,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的分析原发性甲状旁腺功能亢进症(PHPT)甲状旁腺病变声像图特征。方法对临床诊断为PHPT的107例患者术前采集超声图像,以手术切除后病理作为金标准,探讨PHPT的声像图特征。结果对术后病理明确诊断为甲状旁腺病变的107个结节绘制ROC曲线,曲线下面积分别为0.670和0.675,与0.05相比有统计学差异(P=0.005、0.001),故当结节最大直径≤1.55 cm时,残余甲状旁腺征预测甲状旁腺病变的灵敏度和特异度分别为63.0%和63.9%;当结节最大直径≥1.35 cm时,极性供支血管征预测甲状旁腺病变的灵敏度和特异度分别为79.0%和55.6%;当两种征象同时显示时,联合灵敏度和特异度分别为92.2%和35.5%。结论残余甲状旁腺征及极性供支血管征是PHPT时甲状旁腺病变的特征性的声像图改变,且此两种征象的显示与甲状旁腺病变的大小密切相关。Objective To analyze the sonographic features of parathyroid abnormal lesions causing PHPT. Methods A total of 107 patients were enrolled in this retrospective study who had PHPT and underwent parathyroidectomy. Pathology after surgical resection was taken as the gold standard to explore the sonographic features of PHPT. Results ROC curve analysis in 107 abnormal parathyroid lesions showed that the area under the curve was 0.670 and 0.675 respectively, and there was significant difference compared with 0.05(P=0.005,0.001).When the maximum diameter of the nodule was less than 1.55 cm, the sensitivity and specificity of residual parathyroid sign in predicting parathyroid adenoma were 63.0% and 63.9%, respectively. When the maximum diameter of the nodule was greater than 1.35 cm, the sensitivity and specificity of polar donor vessel sign in predicting parathyroid adenoma were 79.0% and 55.6%, respectively. When the two signs were displayed at the same time, the joint sensitivity and specificity were 92.2% and 35.5%, respectively. Conclusions The residual parathyroid sign and polar donor vessel sign are the characteristic sonographic changes of parathyroid lesions in PHPT, and the display of these two signs are closely related to the size of parathyroid lesions.

关 键 词：原发性甲状旁腺功能亢进症 甲状旁腺腺瘤 残余甲状旁腺征 极性供支血管征 

分 类 号：R445.1[医药卫生—影像医学与核医学] R581.1[医药卫生—诊断学]