The Second Department of General Surgery, Zhuhai People's Hospital, Zhuhai City, Guangdong Province, China.
The Department of Ambulant Clinic, Zhuhai People's Hospital, Zhuhai City, Guangdong Province, China.
Clin Endocrinol (Oxf). 2019 Mar;90(3):487-493. doi: 10.1111/cen.13925. Epub 2019 Jan 7.
It may be critical to locate the parathyroid for surgeons during thyroidectomy or parathyroidectomy due to the significant function of the parathyroid in calcium balance. According to recent reports, the intrinsic fluorescence of the parathyroid has been found. There is some evidence supporting that new equipment can detect fluorescence via imaging technology. In this study, a newly invented intraoperative fluorescence imaging system and indocyanine green dye were applied to detect the parathyroid glands and evaluate the vascularization of the parathyroid. The report is as follows.
From 1 May to 8 August 2018, 26 patients underwent total thyroidectomy in Zhuhai People's Hospital and were recruited into our research. All identified parathyroid glands were scored visually from grade 0 to grade 2 according to the vascularity of the parathyroid before ICG angiography was performed. After ICG angiography, parathyroid glands were scored from score 0 to score 2 according to the FI.
Visual scores were significantly higher than ICG angiography scores. In the 22 patients with at least one parathyroid gland with an ICG score of 2, postoperative PTH levels were in the normal range. In the four patients with no parathyroid gland with an ICG score of 2, two of them developed transient hypoparathyroidism, with recovery on POD 7 for the first patient and after 3 months for the second one.
This study has identified that the fluorescence imaging system applied with indocyanine green is a safe, easy and effective method to protect the parathyroid and predict postoperative hypoparathyroidism. Registration number: ChiCTR1800016864.
甲状旁腺在钙平衡中具有重要功能，因此在甲状腺切除术或甲状旁腺切除术期间，外科医生找到甲状旁腺可能至关重要。根据最近的报道，已经发现了甲状旁腺的固有荧光。有一些证据支持新设备可以通过成像技术检测荧光。在这项研究中，应用了一种新发明的术中荧光成像系统和吲哚菁绿染料来检测甲状旁腺并评估甲状旁腺的血管化。现将结果报告如下。
2018 年 5 月 1 日至 8 月 8 日，珠海市人民医院对 26 例接受甲状腺全切除术的患者进行了研究。在进行 ICG 血管造影之前，根据甲状旁腺的血管分布，将所有确定的甲状旁腺从 0 级到 2 级进行视觉评分。在 ICG 血管造影后，根据 FI 将甲状旁腺从 0 级到 2 级进行评分。
视觉评分明显高于 ICG 血管造影评分。在至少有一个 ICG 评分 2 的甲状旁腺的 22 例患者中，术后 PTH 水平在正常范围内。在 4 例 ICG 评分 2 且无甲状旁腺的患者中，其中 2 例发生短暂性甲状旁腺功能减退，第 1 例患者在术后第 7 天恢复，第 2 例患者在 3 个月后恢复。
本研究表明，应用吲哚菁绿的荧光成像系统是一种安全、简便、有效的保护甲状旁腺和预测术后甲状旁腺功能减退的方法。注册号：ChiCTR1800016864。
