超声造影评价甲状旁腺自体异位移植成活价值的初步研究  

Preliminary research of contrast enhanced ultrasound in evaluating the survival value of allotopic autotransplantation

作　　者：陈丹丹 万业达[3] 何辉 刘妍 CHEN Dandan;WAN Yeda;HE Hui;LIU Yan(Graduate School of Tianjin Medical University,Tianjin 300070,China;Department of Ultrasonic Diagnosis,the People's Liberation Army Joint Logistic Support Force 983 Hospital;Department of Radiology I,Tianjin Hospital)

机构地区：[1]天津医科大学研究生院,300070 [2]中国人民解放军联勤保障部队第九八三医院超声诊断科 [3]天津市天津医院放射一科

出　　处：《天津医药》2022年第9期980-983,共4页Tianjin Medical Journal

摘　　要：目的探讨超声造影判定甲状旁腺切除术加自体甲状旁腺异位移植术后移植物是否成活的价值。方法收集因肾功能衰竭并发继发性甲状旁腺功能亢进而行甲状旁腺自体异位移植术的患者17例。每例患者于未行动静脉造瘘术的前臂皮下与脂肪之间移植4枚甲状旁腺组织,共68枚。在移植术后15~21 d进行超声造影检查,观察移植物的血供强化情况,估测移植后的甲状旁腺是否成活并具有分泌功能。按照移植物是否全部出现强化表现分为部分移植成功组与全部移植成功组,并以术后30 d双侧头静脉甲状旁腺激素水平对比判定移植物是否成活。结果17例患者中,全部移植成功组8例,部分移植成功组9例,移植侧头静脉甲状旁腺激素水平高于非移植侧,全部移植成功组头静脉甲状旁腺激素水平高于部分移植成功组,差异有统计学意义(P<0.05)。结论超声造影可以更准确、更有针对性及更早期地评价甲状旁腺自体异位移植的成活率。Objective To investigate the value of contrast enhanced ultrasound(CEUS)in determining graft survival after parathyroidectomy and autologous parathyroid ectopic transplantation.Methods Seventeen patients with renal failure complicated by secondary hyperparathyroidism underwent autotransplantation of parathyroid gland were collected.In each case,4 parathyroid tissues(68 in total)were transplanted between subcutaneous and adipose tissue of the forearm without venostomy.CEUS was performed 15-21 days after transplantation to observe the enhancement of blood supply of the graft and to estimate whether the parathyroid gland survived and had secretory function after transplantation.According to whether all the grafts showed enhancement,the grafts were divided into the partial successful group and the all successful group.The survival of the grafts was determined by comparing the parathyroid hormone(PTH)levels of bilateral cephalic veins 30 days after surgery.Results Among the 17 patients,there were 8 patients in the all successful group and 9 patients in the partial successful group.PTH levels were higher in the cephalic vein of the transplanted side than those of the non-transplanted side.The levels of PTH in the cephalic vein were significantly higher in the all successful group than those in the partial successful group(P<0.05).Conclusion CEUS can assess the survival rate of parathyroidectomy and autotransplantation more accurately and specifically at an earlier stage.

关 键 词：超声检查 多普勒 彩色 造影剂 甲状旁腺 甲状旁腺功能亢进症 继发性 移植 自体 超声造影 成活率 

分 类 号：R445.1[医药卫生—影像医学与核医学]