摘要
目的:评估颈部增强CT对继发性甲状旁腺功能亢进症(SHPT)的术前诊断价值。方法:回顾性分析2018年1月至2019年10月期间在浙江大学附属邵逸夫医院行首次甲状旁腺切除术(PTX)的47例SHPT手术患者的临床资料,比较颈部增强CT、彩色多普勒超声、99mTc-MIBI核素显像3种影像学检查方法的特异度及敏感度;并对增强CT所测甲状腺旁腺大小与术后病理标本进行相关性和一致性分析。结果:颈部增强CT、彩色多普勒超声、99mTc-MIBI核素显像3种影像学检查的敏感度分别为99.40%、63.10%、54.70%;特异度分别为66.60%、88.80%、77.70%;CT的敏感度优于彩色多普勒超声(P=0.001)和99mTc-MIBI核素显像(P=0.006);3种影像学检查的特异度差异均无统计学意义(P>0.05)。术前增强CT所测甲状旁腺最大长径和术后大体病理标本测量的最大径之间具有相关性(r=0.777,P<0.001)和一致性。结论:颈部增强CT对SHPT术前甲状旁腺定位和大小评估具有较好的临床应用价值,可提高手术的精准性。
Objective:To evaluate the value of neck enhanced CT in the diagnosis of secondary hyperparathyroidism(SHPT).Methods:The clinical data of 47 patients with SHPT who underwent the first parathyroidectomy(PTX)in Sir Run Run Shaw Hospital from January 2018 to October 2019 were reviewed.The differences in specificity and sensitivity of neck enhanced CT,color Doppler ultrasound and 99mTc-MIBI radionuclide imaging were tested using the pathological results as the gold standard.The correlation and consistency between the parathyroid size measured by neck enhanced CT and measurement of gross pathological specimens were also analyzed.Results:The sensitivity of neck enhanced CT,color Doppler ultrasound and 99mTc-MIBI radionuclide imaging was 99.40%,63.10%and 54.70%respectively,and the specificity was 66.60%,88.80%and 77.70%.The sensitivity of neck enhanced CT was better than either color Doppler ultrasound(P=0.001)or 99mTc-MIBI radionuclide imaging(P=0.006),while there was no significant difference in specificity(P>0.05).The parathyroid maximum diameter measured by the neck enhanced CT had high correlation(r=0.777,P<0.001)and consistency with the gross pathological specimens.Conclusion:Neck enhanced CT has high diagnastic value in the accurate location diagnosis and size of SHPT,thus it can improve the surgery accuracy of SHPT.
作者
孟娇
李心海
陈昊路
宋春轶
李华
MENG Jiao;LI Xinhai;CHEN Haolu;SONG Chunyi;LI Hua(Department of Nephrology,Sir Run Run Shaw Hospital Xiasha Campus,Zhejiang University School of Medicine,Hangzhou 310016,China;Department of Radiology,Sir Run Run Shaw Hospital Xiasha Campus,Zhejiang University School of Medicine,Hangzhou 310016,China;Department of Head and Neck Surgery,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine,Hangzhou 310016,China)
出处
《温州医科大学学报》
CAS
2021年第3期215-219,共5页
Journal of Wenzhou Medical University
基金
浙江省自然科学基金资助项目(Y15H050011)。
