接受过手术的甲状旁腺腺瘤患者的定位。第二部分。侵入性操作。

Localization of parathyroid adenomas in patients who have undergone surgery. Part II. Invasive procedures.

作者信息

Miller D L, Doppman J L, Krudy A G, Shawker T H, Norton J A, Vucich J J, Morrish K A, Marx S J, Spiegel A M, Aurbach G D

出版信息

Radiology. 1987 Jan;162(1 Pt 1):138-41. doi: 10.1148/radiology.162.1.3538146.

DOI:10.1148/radiology.162.1.3538146

PMID:3538146

Abstract

The authors studied intraarterial digital subtraction angiography (DSA), conventional selective angiography, parathyroid venous sampling (PVS), and intraoperative ultrasound (US) as localization procedures for parathyroid adenomas in 53 patients with proved parathyroid adenomas and previous unsuccessful parathyroid surgery. PVS had the highest overall sensitivity as a single study (80%), followed by intraoperative US (78%), angiography (60%), and DSA (49%). Invasive procedures permitted successful localization of adenomas in 41 of 43 patients studied (95%). False-positive studies were uncommon. The optimum sequence of invasive localization procedures is determined by clinical factors and not by the sensitivity of individual tests. The authors recommend DSA be performed first, followed by angiography, PVS, and intraoperative US, in that order.

摘要

作者对53例已证实患有甲状旁腺腺瘤且先前甲状旁腺手术失败的患者，研究了动脉内数字减影血管造影（DSA）、传统选择性血管造影、甲状旁腺静脉采血（PVS）和术中超声（US）作为甲状旁腺腺瘤的定位方法。作为单一检查，PVS的总体敏感性最高（80%），其次是术中超声（78%）、血管造影（60%）和DSA（49%）。侵入性检查使43例接受研究的患者中的41例（95%）成功定位了腺瘤。假阳性检查并不常见。侵入性定位检查的最佳顺序由临床因素决定，而非由单个检查的敏感性决定。作者建议按此顺序首先进行DSA，其次是血管造影、PVS和术中超声。