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[珊瑚状肾结石患者甲状旁腺的超声研究]

[Ultrasonic study of the parathyroid glands in patients with coralliform nephrolithiasis].

作者信息

Ianenko E K, Ignashin N S, Demin A I, Borisik V I

出版信息

Urol Nefrol (Mosk). 1990 May-Jun(3):6-8.

PMID:2204168
Abstract

Functional activity of the parathyroid glands (PTG) is important for the choice of proper therapeutic policy in patients with dendritic nephrolithiasis. The location of the hyperfunctioning gland (usually adenomatously or hyperplastically changed) is a complicated problem as the dimensions of the gland are extremely small. Ultrasonic investigation of the parathyroid gland area for detection of the enlarged gland is used at the Research Institute of Urology, the RSFSR Ministry of Health. Linear (7.5 mHz) and sector (5 mHz) transducers have been used through the water medium and by the immediate contact with the surface of the patient's neck. A total of 24 subjects were enrolled in the study (13 females and 11 males aged 23-64 years). Enlarged parathyroid glands situated in the lower thyroid lobe (low parathyroid glands) or in the upper medial third of the thyroid lobe (upper parathyroid glands) were recorded in 9 patients and confirmed in the course of surgeries. In one case, the enlarged parathyroid gland was found in the thyroid tissue. Its length varied from 0.6 to 1.5 cm and its thickness, from 0.4 to 0.9 cm. All the glands were echographically evidenced as oval formations with a low-rate echogeneity and clear-cut smooth contours. In 3 cases the site of the gland was confirmed by a selective testing of the neck venous blood for parathyroid hormone. Histological examination of the removed glands revealed that hyperplastic changes were more common than the adenomatous ones.

摘要

甲状旁腺(PTG)的功能活动对于选择合适的治疗方案来治疗树枝状肾结石患者非常重要。由于腺体尺寸极小,确定功能亢进腺体(通常为腺瘤样或增生性改变)的位置是一个复杂的问题。苏联卫生部俄罗斯联邦共和国泌尿学研究所采用超声检查甲状旁腺区域以检测增大的腺体。通过水介质并直接接触患者颈部表面使用线性(7.5兆赫兹)和扇形(5兆赫兹)换能器。共有24名受试者参与研究(13名女性和11名男性,年龄在23至64岁之间)。在9名患者中记录到位于甲状腺下叶(低位甲状旁腺)或甲状腺叶上内侧三分之一处(高位甲状旁腺)的甲状旁腺增大,并在手术过程中得到证实。在1例中,在甲状腺组织中发现了增大的甲状旁腺。其长度从0.6厘米到1.5厘米不等,厚度从0.4厘米到0.9厘米不等。所有腺体在超声检查中均显示为椭圆形结构,回声率低,轮廓清晰光滑。在3例中,通过对颈部静脉血进行甲状旁腺激素的选择性检测确定了腺体的位置。对切除腺体的组织学检查显示,增生性改变比腺瘤样改变更为常见。

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