对于术前锝[99mTc]甲氧基异丁基异腈扫描未明确定位的患者，超声有助于进行微创甲状旁腺切除术。
Ultrasound facilitates minimally invasive parathyroidectomy in patients lacking definitive localization from preoperative sestamibi scan.
作者信息
Davis Matthew L, Quayle Frank J, Middleton William D, Acosta Lori M, Hix-Hernandez Staci J, Snyder Samuel K, Moley Jeffrey F, Brunt L Michael, Lairmore Terry C
机构信息
Department of Surgery, Scott & White Memorial Hospital and the Scott, Sherwood and Brindley Foundation, Texas A&M University System Health Science Center College of Medicine, 2401 S. 31st St, Temple, TX 76508, USA.
出版信息
Am J Surg. 2007 Dec;194(6):785-90; discussion 790-1. doi: 10.1016/j.amjsurg.2007.07.020.
BACKGROUND
Sestamibi scanning is commonly used for preoperative localization in patients with hyperparathyroidism. However, 12% to 15% of these studies are equivocal or negative. Ultrasound may also be used to identify patients suitable for a minimally invasive parathyroidectomy.
METHODS
Data from patients treated for hyperparathyroidism between January 2000 and April 2006 were reviewed retrospectively. Sestamibi and ultrasound results were scored as definitive, suggestive, or negative. Patients with suggestive or negative sestamibi scans were included in the analysis.
RESULTS
A total of 261 patients underwent operation without a definitively localizing sestamibi scan. Preoperative neck ultrasound was performed in 80 of these patients. Overall, ultrasound was either conclusive or suggestive in 45 of 80 patients (56%) without a definitively localizing sestamibi scan and correctly correlated with the surgical findings in 38 of 45 (84%) of these patients.
CONCLUSION
In patients with nonlocalizing sestamibi scans, neck ultrasound increases the number of patients suitable for minimally invasive parathyroidectomy.
背景
甲氧基异丁基异腈扫描常用于甲状旁腺功能亢进患者的术前定位。然而，这些检查中有12%至15%的结果不明确或为阴性。超声也可用于识别适合微创甲状旁腺切除术的患者。
方法
回顾性分析2000年1月至2006年4月接受甲状旁腺功能亢进治疗的患者数据。甲氧基异丁基异腈和超声检查结果分为明确、提示性或阴性。甲氧基异丁基异腈扫描结果为提示性或阴性的患者纳入分析。
结果
共有261例患者未进行明确的甲氧基异丁基异腈扫描就接受了手术。其中80例患者术前行颈部超声检查。总体而言，在80例未进行明确的甲氧基异丁基异腈扫描的患者中，45例（56%）的超声检查结果为确定性或提示性，其中38例（84%）与手术结果正确相关。
结论
对于甲氧基异丁基异腈扫描未定位的患者，颈部超声可增加适合微创甲状旁腺切除术的患者数量。
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