Varsamidis K, Varsamidou E, Mavropoulos G
Department of Radiology, 2nd IKA General Hospital, Thessaloniki, Greece.
Head Neck. 1999 Oct;21(7):648-51. doi: 10.1002/(sici)1097-0347(199910)21:7<648::aid-hed9>3.0.co;2-s.
Various diagnostic modalities have been utilized to aid in the detection of abnormal parathyroid tissue; however, its localization is not always easy. The purpose of this study was to determine whether the evaluation of potential hemodynamic changes in thyroid arteries could aid in the detection of parathyroid adenomas.
Twenty-eight patients with laboratory evidence of hyperparathyroidism were examined with color Doppler sonography. Data were collected for the superior and inferior thyroid arteries separately. These findings were compared with data for a control group of 14 healthy subjects.
Retrospective analysis of the data indicated that peak systolic velocities in the inferior thyroid arteries ipsilateral with the parathyroid adenomas were significantly higher than in normal controls (p <.001). Peak velocity values in the superior thyroid arteries ipsilateral with parathyroid adenomas located in the upper position were also significantly increased compared with those in control subjects (p <. 02). Conversely, peak velocities in the inferior and superior thyroid arteries contralateral with the adenomas, as well as velocities in the superior thyroid arteries ipsilateral with lower position adenomas, did not differ significantly from those in control subjects. The localization of both side and level site of the adenomas presented an accuracy of 86.6%, sensitivity reached 96. 5%, and specificity 83.1%.
Our results suggest that color Doppler sonography can be used to improve diagnostic accuracy in detecting parathyroid adenomas.
已采用多种诊断方法辅助检测异常甲状旁腺组织;然而,其定位并不总是容易的。本研究的目的是确定评估甲状腺动脉潜在血流动力学变化是否有助于甲状旁腺腺瘤的检测。
对28例有甲状旁腺功能亢进实验室证据的患者进行彩色多普勒超声检查。分别收集甲状腺上动脉和下动脉的数据。将这些结果与14名健康受试者的对照组数据进行比较。
对数据的回顾性分析表明,甲状旁腺腺瘤同侧甲状腺下动脉的收缩期峰值流速显著高于正常对照组(p<.001)。位于上方的甲状旁腺腺瘤同侧甲状腺上动脉的峰值流速值与对照组相比也显著增加(p<.02)。相反,腺瘤对侧甲状腺下动脉和上动脉的峰值流速,以及低位腺瘤同侧甲状腺上动脉的流速与对照组相比无显著差异。腺瘤双侧及水平位置的定位准确率为86.6%,敏感性达96.5%,特异性为83.1%。
我们的结果表明,彩色多普勒超声可用于提高甲状旁腺腺瘤检测的诊断准确性。