甲状旁腺病变的术前定位：彩色多普勒超声检查的诊断价值
Preoperative localization of parathyroid lesion: diagnostic usefulness of color doppler ultrasonography.
作者信息
Mohammadi Afshin, Moloudi Farzad, Ghasemi-Rad Mohammad
机构信息
Department of Radiology, Urmia University of Medical Sciences, Urmia, West Azerbaijan, Iran.
出版信息
Int J Clin Exp Med. 2012;5(1):80-6. Epub 2012 Jan 15.
INTRODUCTION
Recently, minimally invasive parathyroidectomy (MIP) has been developed and is gaining popularity among surgeons. For this reason, preoperative localization is playing an important role to detect the precise location of the affected gland and to increase the success rate.
MATERIAL AND METHODS
From June 2007 to June 2011, 56 consecutive patients (11 men and 45 women) with primary or secondary hyperparathyroidism in our center underwent Gray scale, color Doppler and 99m-Tc MIBI scan prior to operative management of parathyroid lesions.
RESULTS
The sensitivity, specificity and accuracy of US and MIBI scan for pHPT was 88%, 94%, 91% and 70%, 100% and 85% respectively. In patients with sHPT, the sensitivity, specificity and accuracy of US and MIBI scan was 54%, 93%, 76% and 25%, 100% and 72.9% respectively. The overall sensitivity of combined US and MIBI scan in pHPT and sHPT was 97% and 45% respectively. The overall sensitivity, specificity and accuracy of CDUS in diagnosis of parathyroid lesions in pHPT and sHPT is 97%, 100%, 98.6% and 62%, 100% and 83% respectively.
CONCLUSION
The overall sensitivity and specificity of US and MIBI in preoperative localization of parathyroid adenoma in sHPT is lower than pHPT and performing CDUS can increases the overall sensitivity and specificity of imaging methods in accurate localization of parathyroid lesion.
引言
近年来，微创甲状旁腺切除术（MIP）得以发展并在外科医生中越来越受欢迎。因此，术前定位对于检测受累腺体的精确位置及提高成功率起着重要作用。
材料与方法
2007年6月至2011年6月，本中心56例连续性原发性或继发性甲状旁腺功能亢进患者（11例男性，45例女性）在接受甲状旁腺病变手术治疗前接受了灰阶、彩色多普勒及99m锝甲氧基异丁基异腈（99m-Tc MIBI）扫描。
结果
超声（US）和MIBI扫描对原发性甲状旁腺功能亢进（pHPT）的敏感性、特异性和准确性分别为88%、94%、91%以及70%、100%、85%。在继发性甲状旁腺功能亢进（sHPT）患者中，US和MIBI扫描的敏感性、特异性和准确性分别为54%、93%、76%以及25%、100%、72.9%。US与MIBI联合扫描在pHPT和sHPT中的总体敏感性分别为97%和45%。彩色多普勒超声（CDUS）诊断pHPT和sHPT甲状旁腺病变的总体敏感性、特异性和准确性分别为97%、100%、98.6%以及62%、100%、83%。
结论
US和MIBI在sHPT甲状旁腺腺瘤术前定位中的总体敏感性和特异性低于pHPT，而进行CDUS可提高影像方法在甲状旁腺病变准确定位中的总体敏感性和特异性。
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