Antakia Ramez, Brown Brian H, Highfield Peter E, Stephenson Tim J, Brown Nicola J, Balasubramanian Sabapathy P
University of Sheffield, Sheffield, UK
University of Sheffield, Sheffield, UK.
Surg Innov. 2016 Apr;23(2):176-82. doi: 10.1177/1553350615607639. Epub 2015 Sep 30.
Accurate identification of parathyroid glands during thyroid surgery is crucial to avoid postthyroidectomy hypocalcemia. Electrical impedance spectroscopy has the potential to differentiate between tissues of different morphology. The aim of this study was to determine the electrical impedance patterns of the thyroid, parathyroid, and other soft tissue structures in the rabbit neck.
The central compartments were exposed in 9 freshly culled New Zealand White rabbits. In situ and ex vivo electrical impedance was measured from thyroid lobes, external parathyroid glands, adipose tissue, and strap muscle using the APX100 device. Specimens of all identified glands were sent for histopathology examination.
Histology confirmed correct identification of all excised thyroid and parathyroid glands. The impedance was higher for thyroid tissue at lower frequencies and for parathyroid tissue at higher frequencies. Ex vivo electrical impedance spectra were significantly higher compared with the in situ spectra across all frequencies for thyroid and parathyroid tissues (P < .001). The ratio of low to high frequency in situ impedance of thyroid, parathyroid, and muscle was significantly different (P < .001), allowing for differentiation between these tissues.
The electrical impedance spectra of rabbit thyroid and parathyroid glands are distinct and different from each other and from skeletal muscle. If these results are replicated in human tissue, they have the potential to improve patient outcomes by achieving early identification and preservation of parathyroid glands.
甲状腺手术中准确识别甲状旁腺对于避免甲状腺切除术后低钙血症至关重要。电阻抗光谱法有区分不同形态组织的潜力。本研究的目的是确定兔颈部甲状腺、甲状旁腺及其他软组织结构的电阻抗模式。
对9只刚处死的新西兰白兔暴露其中心腔室。使用APX100设备测量甲状腺叶、甲状旁腺、脂肪组织和带状肌的原位和离体电阻抗。所有识别出的腺体标本均送去做组织病理学检查。
组织学证实所有切除的甲状腺和甲状旁腺均被正确识别。甲状腺组织在较低频率时电阻抗较高，甲状旁腺组织在较高频率时电阻抗较高。甲状腺和甲状旁腺组织在所有频率下的离体电阻抗谱均显著高于原位谱（P <.001）。甲状腺、甲状旁腺和肌肉的原位低频与高频电阻抗之比有显著差异（P <.001），可区分这些组织。
兔甲状腺和甲状旁腺的电阻抗谱彼此不同，且与骨骼肌不同。如果这些结果能在人体组织中得到重复，它们有可能通过早期识别和保留甲状旁腺来改善患者预后。
