甲状旁腺肿物超声误漏诊分析  

Analysis of Ultrasonic Misdiagnosis of Parathyroid Neoplasm

作　　者：葛喜凤 张丽[1] 崔立刚[1] 陈文[1] Ge Xifeng;Zhang Li;Cui Ligang;Chen Wen(Ultrasound Department of Peking University Third Hospital,Beijing,100191,China)

机构地区：[1]北京大学第三医院超声诊断科,北京市100191

出　　处：《中国超声医学杂志》2021年第8期937-940,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的分析甲状旁腺肿物漏误诊原因并总结其超声特点。方法回顾性分析超声甲状旁腺肿物漏误诊病例22例。结果误诊最常见原因为与甲状腺结节发生混淆,超过总病例数的54.5%(12/22),1例将甲状腺结节误诊为甲状旁腺肿物,11例将甲状旁腺肿物误诊为甲状腺结节,其超声特点有:5例合并囊性变,5例与甲状腺间无厚分隔,6例血流信号不丰富,8例合并甲状腺结节。其次4例与淋巴结发生混淆,其中2例将淋巴结误诊为甲状旁腺肿物,2例将甲状旁腺肿物误诊为淋巴结。漏诊最常见为异位甲状旁腺肿物,共4例,另有漏诊体积小及扁长形甲状旁腺肿物各1例。结论甲状旁腺肿物在合并囊性变、无包膜、血流信号不丰富、邻近甲状腺内存在多发结节时最易被误诊为甲状腺结节,出现形态异常、体积较小及位置异常时易漏诊,结合核医学检查结果及甲状旁腺激素水平有助于减少漏误诊发生。Objective To analyze the causes of misdiagnosis of parathyroid neoplasm and summarize their ultrasonic characteristics. Methods 22 misdiagnosed cases of parathyroid neoplasm were retrospectively analyzed. Results Most of the parathyroid neoplasm were confused with thyroid nodules(12/22), accounting for more than 54.5%. Among them, 1 case of thyroid nodule was mistaken as parathyroid neoplasm and 11 cases were mistaken for thyroid nodules, their ultrasound characteristics include: 5 cases combination of cystic change, 5 cases without thick septum between thyroid, 6 cases with a hypovascular pattern, and 8 cases coexistence with multiple thyroid nodules. Besides that, 4 cases were confused with lymph node. In which 2 cases of parathyroid neoplasm were mistaken as cervical lymph nodes, while two additional cases of cervical lymph nodes were mistaken as parathyroid neoplasm. 4 cases were missed diagnosis because of ectopic parathyroid gland. Other missed diagnosis included one case of small gland and one of long strip shape. Conclusions Parathyroid neoplasm tends to be confused with thyroid nodule when it combined with cystic change, without an obvious capsule, with a hypovascular pattern, or coexistence with multiple thyroid nodules. It may be missed diagnosis because of morphological abnormalities, small or ectopic ones. Combined with the results of the level of parathyroid(PTH) and nuclear medicine could help to reduce the incidence of misdiagnosis.

关 键 词：原发性 甲状旁腺 超声诊断 漏误诊 

分 类 号：R445.1[医药卫生—影像医学与核医学] R582[医药卫生—诊断学]