超声检测血流成像评估原发性甲状旁腺功能亢进症患者的甲状旁腺腺瘤

Ultrasonographic Detective Flow Imaging for Evaluating Parathyroid Adenoma in Patients with Primary Hyperparathyroidism.

作者信息

Akasu Haruki, Jikuzono Tomoo, Matsui Mami, Sen Masaomi, Saitou Marie, Ishibashi Osamu, Sugitani Iwao

机构信息

Department of Endocrine Surgery, Nippon Medical School Musashi Kosugi Hospital.

Department of Endocrine Surgery, Nippon Medical School.

出版信息

J Nippon Med Sch. 2024;91(2):227-232. doi: 10.1272/jnms.JNMS.2024_91-213.

DOI:10.1272/jnms.JNMS.2024_91-213

PMID:38777783

Abstract

BACKGROUND

Detective flow imaging (DFI) is a new imaging technology that displays low-velocity blood flow, which is difficult to visualize on conventional color Doppler ultrasonography (CDU). In this study, we compared the usefulness of DFI with that of CDU and methoxy-isobutyl-isonitrile (MIBI) scintigraphy for detecting parathyroid adenoma (PA) in patients with primary hyperparathyroidism (PHPT).

METHODS

From March 2021 to March 2023, 87 PHPT patients underwent surgery, and 66 had a single PA. We performed preoperative conventional ultrasonography with CDU, MIBI scintigraphy, and DFI for 42 patients (5 males and 37 females; mean age: 61.6 ± 15.4 years).

RESULTS

MIBI scintigraphy detected PA in 85.7% (36/42) patients, and both CDU and DFI detected PA in all patients. The rates of vascularity in PA detected by CDU and DFI were 71.4% (30/42) and 85.7% (36/42), respectively. Vascularity was detected by DFI in 6 patients who were negative for vascularity on MIBI scintigraphy. Furthermore, DFI detected blood supply in 6 of the 12 patients with undetectable blood supply on CDU. Fisher's exact test revealed that high or low blood flow, as determined by DFI, was significantly associated with detection of feeding vessels in PA by CDU (P < 0.001).

CONCLUSIONS

DFI was useful for preoperative detection of PA blood flow.

摘要

背景

检测血流成像（DFI）是一种可显示低速血流的新成像技术，而低速血流在传统彩色多普勒超声检查（CDU）中难以显现。在本研究中，我们比较了DFI与CDU以及甲氧基异丁基异腈（MIBI）闪烁扫描术在检测原发性甲状旁腺功能亢进症（PHPT）患者甲状旁腺腺瘤（PA）方面的效用。

方法

2021年3月至2023年3月，87例PHPT患者接受了手术，其中66例有单个PA。我们对42例患者（5例男性和37例女性；平均年龄：61.6±15.4岁）进行了术前常规超声检查、CDU、MIBI闪烁扫描术和DFI检查。

结果

MIBI闪烁扫描术在85.7%（36/42）的患者中检测到PA，而CDU和DFI在所有患者中均检测到PA。CDU和DFI检测到的PA中的血管化率分别为71.4%（30/42）和85.7%（36/42）。DFI在6例MIBI闪烁扫描术血管化呈阴性的患者中检测到血管化。此外，DFI在12例CDU未检测到血供的患者中的6例中检测到了血供。Fisher精确检验显示，DFI所确定的高血流或低血流与CDU检测到的PA中的供血血管显著相关（P<0.001）。