摘要
目的探讨多模式超声在无功能性甲状旁腺囊肿诊断中的应用价值。方法总结甲状旁腺囊肿的超声影像特征,分析比较经病理明确诊断的32例甲状旁腺囊肿的二维、彩色多普勒、超声造影、三维容积重建等超声影像表现,并在超声引导下经皮穿刺抽取11例甲状旁腺囊肿的囊液进行理化分析。结果 32例甲状旁腺囊肿的超声影像表现:二维超声上囊肿均表现为位于下甲状旁腺区突出于甲状腺外的类圆形囊性结节(左下18例,右下14例),吞咽时与同侧甲状腺呈不同步运动,加压探头时可见囊肿与甲状腺分离,囊肿境界清晰,囊壁光滑,囊液透声良好,其内无点状强回声或漂浮的细密点状回声;彩色多普勒超声上显示囊肿囊壁上未见明确的血流信号;超声造影显示结节内无造影剂充填,但囊肿囊壁呈细线状等增强;11例甲状旁腺囊肿经三维容积重建算得体积为2.12~12.89 ml,平均(6.24±2.99)ml,实际抽取囊液量2~12 ml,平均(6.18±2.89)ml,三维容积重建算得的体积与实际抽取的囊液量比较差异无统计学意义(P>0.05)。实际抽取的囊液均为无色、透明、稀薄、清亮的液体,囊液的甲状旁腺激素(parathyroid hormone,PTH)测定结果均高于血清的正常值上限,测得结果 98~205 pg/ml,平均(123.25±32.39)pg/ml。结论充分掌握甲状旁腺囊肿的超声影像表现,则有利于提高该病超声诊断率。囊液的PTH定量分析是可靠的术前诊断方法,安全微创,值得临床推广。
Objective To investigate the application value of multi-mode ultrasonography in the diagnosis of non-functioning parathyroid cysts. Methods The features of multi-mode ultrasonography of 32 non-functioning parathyroid cysts were summarized. The ultrasonographic manifestations of 2 D-US,CDFI,3 D-US,in 11 pathologically confirmed parathyroid cysts were analyzed and compared,and physicochemical analysis of the fluid aspirated in 11 cysts under ultrasonograph was also performed in the process. Results Ultrasonography manifestations of 32 parathyroid cysts were as follows： all cysts were located in the lower parathyroid area（ bottom left：18 cases,bottom right：14 cases）. With swallowing,the cysts were not dissonant in movement with the thyroid at the same side,and pressed probe revealed that the cysts were separated with the thyroid,with clear periphery,smooth cyst wall and strong sound transmission and without internal echo or floating small point-shape echo. Color Doppler detection revealed that there was no obvious blood flow signal in the cyst wall. Ultrasonography revealed that there was no contrast medium in the nodules,but the cyst wall displayed isoechoic. The volume calculated by 3 D-US of the 11 parathyroid cysts was 2. 12-12. 89 ml,with an average volume of（6. 24 ± 2. 99） ml. Actual volume was 2-12 ml,with an average volume of（6. 18 ± 2. 89） ml,and there was no statistical significance in the volume calculated by 3 D-US and actual volume,when comparisons were made between them（ P〈0. 05）. The cyst fluid was colorless,transparent,thin and clear. Detection results of parathyroid hormone（ PTH）（98-205 pg/ml） were all higher than the upper limit of the serum norm,with an average volume of（123. 25 ± 32. 39） pg/ml. Conclusion Full knowledge of ultrasonic manifestations was beneficial to higher rate of ultrasonographic diagnosis. Quantitative analysis of cyst fluid was a sure diagnostic method with good safety and mini invasion,which was worth further clinical extension.
作者
赵璐璐
章建全
Zhao Lulu;Zhang Jianquan(Department of Ultrasonography, Changhai Hospital Affiliated to Navy Medical University,Shanghai 200433, Chin)
出处
《海军医学杂志》
2018年第2期155-157,161,共4页
Journal of Navy Medicine
关键词
甲状旁腺囊肿
超声诊断
多模式超声
囊液PTH测定
Parathyroid cysts
Ultrasonographic diagnosis
Multi-mode ultrasonography
Cyst fluid PTH detection
