超声、核素及CT对原发性甲状旁腺功能亢进症术前定位诊断价值的研究  

Value of ultrasonography,radionuclide imaging and CT in preoperative location diagnosis of primary hyperparathyroidism

作　　者：徐奇奇 孔娜 梁春蕊 崔爱民[1] 张自琴[1] 谭屾[1] 柏楠[1] Xu Qiqi;Kong Na;Liang Chunrui;Cui Aimin;Zhang Ziqin;Tan Shen;Bai Nan(Deparment of General Surgery,Beijing Jishuitan Hospital,Beijing 100035,China;Department of Ultrasound,Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]北京积水潭医院(北京大学第四临床医学院)普通外科,100035 [2]北京积水潭医院(北京大学第四临床医学院)超声科,100035

出　　处：《中华普通外科杂志》2021年第12期922-925,共4页Chinese Journal of General Surgery

摘　　要：目的研究超声、核素及CT在原发性甲状旁腺功能亢进症(PHPT)中的术前定位诊断价值。方法回顾性分析1992年1月至2020年12月北京积水潭医院170例PHPT患者的临床资料,对比超声、核素、CT三种检查单独或联合使用的术前定位诊断效能。结果所有患者的超声、核素及CT定位总灵敏度分别为82.13%、80.43%、75.74%。正常位置腺瘤的定位灵敏度:超声(86.67%)高于核素(81.82%,P<0.05)、CT(80.59%,P<0.05),超声加CT并联(94.70%,P<0.05)高于单独使用超声;定位特异度:核素(97.78%)高于超声(91.62%)、CT(93.39%),超声加核素串联(99.00%,P<0.001)、超声加CT串联(96.94%,P<0.001)均高于单独使用超声(91.62%)。对异位腺瘤、甲状旁腺增生:核素灵敏度、特异度均高于超声、CT,但差异无统计学意义(P>0.05)。结论超声是PHPT术前定位诊断的首选方法,超声联合核素或CT检查能显著提高对甲状旁腺病灶的诊断率。Objectiv To evaluate ultrasound,radionuclide imaging and CT in preoperative localization diagnosis of primary hyperparathyroidism(PHPT).Method A total of 170 PHPT patients admitted to the hospital between Jan 1992 and Dec 2020 were analyzed retrospectively.The preoperative localization diagnostic efficacy of ultrasonography,radionuclide and CT alone and in combination was compared in groups.Results The overall sensitivity of ultrasound,radionuclide and CT were 82.13%,80.43%and 75.74%.For normal positioned parathyroid adenoma:as for sensitivity of location diagnosis,ultrasound(86.67%)was higher than radionuclide(81.82%,P<0.05)and CT(80.59%,P<0.05),ultrasound/CT parallel test(94.70%,P<0.05)was higher than ultrasound alone.For specificity of location diagnosis,radionuclide(97.78%)was higher than ultrasound(91.62%)and CT(93.39%),both ultrasound/radionuclide series tests(99.00%,P<0.001)and ultrasound/CT series tests(96.94%,P<0.001)were higher than ultrasound alone.In case of ectopic parathyroid adenoma and parathyroid hyperplasia:the sensitivity and specificity of radionuclide seemed higher than ultrasound and CT.Conclusions Ultrasound is the first choice for preoperative location diagnosis of PHPT.Ultrasound combined with radionuclide or CT can significantly improve the diagnostic efficiency of parathyroid lesions.

关 键 词：甲状旁腺功能亢进 原发性 超声检查 多普勒 彩色 放射性核素显像 体层摄影术 X线计算机 

分 类 号：R653[医药卫生—外科学]