摘要
目的 分析超声定位原发性甲状旁腺功能亢进症(PHPT)漏、误诊原因。方法 回顾性分析92例术前超声定位漏、误诊PHPT患者共96个病灶,观察病灶超声表现。结果 超声漏诊64个病灶的中位最大径为1.3 cm, 32个位于甲状腺背侧、16个位于甲状腺上极上方或下极下方、16个异位;48个甲状腺背侧、上极上方及下极下方病灶中,26个(26/48,54.17%)病灶厚度≤0.5 cm。超声误诊27个病灶为甲状腺结节,其中位最大径为1.8 cm,其中17个紧邻甲状腺被膜,7个部分、3个完全位于甲状腺内;6个呈均匀低回声,19个为混合回声,2个为中高回声。超声误诊5个病灶为淋巴结,其中位最大径为1.1 cm, 2个呈均匀低回声、3个呈混合回声(2个周边低回声、内部中高回声,1个周边中高回声、内部低回声)。结论 超声定位PHPT漏、误诊与病灶体积小、呈薄片状或异位等因素有关;应注意鉴别甲状旁腺病变、甲状腺结节与淋巴结。
Objective To explore the causes of missed diagnosis and misdiagnosis of ultrasound localization of primary hyperparathyroidism(PHPT).Methods Data of 96 parathyroid lesions in 92 PHPT patients missed diagnosis or misdiagnosed by preoperative ultrasound localization were retrospectively analyzed,and ultrasound manifestations of these lesions were observed.Results Ultrasound missed 64 lesions with a median maximum diameter of 1.3 cm,including 32 lesions in the dorsal region of the thyroid,16 above or below the poles of the thyroid and 16 ectopic lesions.Among 48 missed lesions in the dorsal region of the thyroid,above or below the poles of thyroid,26(26/48,54.17%)had a thickness≤0.5 cm.Ultrasound misdiagnosed 27 lesions as thyroid nodules,with a median maximum diameter of 1.8 cm,including 17 closely adjacent to thyroid,7 incompletely and 3 completely intrathyroid,among which 6 were homogeneously hypoechoic,19 were mixed echogenic and 2 were isoechoic or hyperechoic.Ultrasound misdiagnosed 5 lesions as lymph nodes,with the median maximum diameter of 1.1 cm,including 2 homogeneously hypoechoic and 3 mixed echogenic(2 with peripheral hypoechoic and internal hyperechoic and 1 with peripheral hyperechoic and internal hypoechoic).Conclusion Missed diagnosis and misdiagnosis of ultrasound localization of PHPT were associated with small size,elongated shape and ectopic locations.Attention should be given to differentiating parathyroid lesions with thyroid nodules and lymph nodes.
作者
方嵩
刘赫
朱庆莉
吕珂
李建初
姜玉新
FANG Song;LIU He;ZHU Qingli;LYU Ke;LI Jianchu;JIANG Yuxin(Department of Ultrasound,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730,China)
出处
《中国医学影像技术》
CSCD
北大核心
2024年第3期351-355,共5页
Chinese Journal of Medical Imaging Technology
基金
中央高水平医院临床科研专项(2022-PUMCH-B-065)。
