Research Unit for ORL - Head & Neck Surgery and Audiology, Odense University Hospital, Odense, Denmark.
Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
Endocrine. 2024 Dec;86(3):1131-1139. doi: 10.1007/s12020-024-03986-y. Epub 2024 Aug 8.
To evaluate the potential benefit of adding a low frequency vascular probe to the conventional pre-operative ultrasound examination of patients with primary hyperparathyroidism.
A prospective cohort of 136 patients with primary hyperparathyroidism underwent a conventional ultrasound examination of the neck with a high frequency ( > 10 MHz) linear ultrasound probe, followed by an add-on examination with a low frequency vascular probe. For each ultrasound probe, and for every potential parathyroid lesion, the presence of a feeding vessel, a polar placement of the feeding vessel, and the presence of a vascular arch was recorded.
A total of 146 ultrasound lesions were evaluated for vascularity by each probe. For both ultrasound probes, the odds of a hyperfunctioning parathyroid gland being correctly identified increased with the number of visible vascular features. The vascular probe identified a significantly higher number of vascular features among ultrasound true positive glands compared with the conventional probe (p < 0.0001). Among histopathologically verified pathological parathyroid glands, the vascular probe identified 20% more feeding vessels, 27% more polar placements of the feeding vessel, and 65% more vascular arches than the high frequency probe. However, the diagnostic confidence score for true positive glands did not differ significantly between the probes (p = 0.11).
The addition of a low frequency vascular probe increases the number of visible vascular features in hyperfunctioning parathyroid glands, which facilitates their preoperative detection. Whether or not this can increase the diagnostic confidence of ultrasound examiners has yet to be substantiated.
评估在原发性甲状旁腺功能亢进症患者的常规术前超声检查中添加低频血管探头的潜在益处。
对 136 例原发性甲状旁腺功能亢进症患者进行前瞻性队列研究，这些患者接受了高频（>10MHz）线性超声探头的颈部常规超声检查，随后使用低频血管探头进行附加检查。对于每个超声探头和每个潜在的甲状旁腺病变，记录是否存在供血血管、供血血管的极性位置以及是否存在血管弓。
通过每个探头共评估了 146 个超声病变的血管情况。对于两种超声探头，随着可见血管特征数量的增加，功能亢进的甲状旁腺被正确识别的可能性增加。与传统探头相比，血管探头在超声阳性腺体中识别出的血管特征明显更多（p<0.0001）。在经组织病理学证实的病理性甲状旁腺中，血管探头比高频探头多识别出 20%的供血血管、27%的供血血管极性位置和 65%的血管弓。然而，两种探头的阳性腺体的诊断置信评分没有显著差异（p=0.11）。
添加低频血管探头可增加功能亢进的甲状旁腺中可见的血管特征数量，有助于术前检测。这是否能提高超声检查者的诊断信心还有待证实。
