| 摘要: |
| 目的 探讨正常甲状旁腺在高频超声、彩色及能量多普勒超声、超声弹性检查、超声造影中的影像特征及显示位置，为临床甲状腺切除术中正常甲状旁腺的保护提供指导性依据。方法 选取220例正常成人和60例合并甲状腺肿瘤拟甲状腺全切除者，均行甲状旁腺超声检查，以甲状腺为基础作位置标记，行高频超声、彩色及能量多普勒超声检查，其中50例正常成人同时行超声弹性检查，20例正常成人同时进行了超声造影检查，分析总结正常甲状旁腺的超声影像特征及位置。60例甲状腺全切除者分为术中行超声检测30例，未行超声检测30例，比较两者术后甲状旁腺功能低下的发生率。结果 ①280例受检者中甲状旁腺显示217例，高频超声显示率77.5%（217/280），多表现为边界清晰的椭圆形高回声及稍高回声小结；共显示412枚甲状旁腺，位于甲状腺上极后方36枚（8.7%）、体部后方138枚（33.5%）、下极后方179枚（43.5%）、侧叶下方2 cm内59枚（14.3%）。②彩色及能量多普勒超声可显示血流信号301枚（73.0%）。③50例正常甲状旁腺超声弹性成像测得弹性值为（12.3±2.1）kPa，相邻正常甲状腺弹性值为（27.2±2.5）kPa，差异有统计学意义（P＜0.05）。④20例正常甲状旁腺超声造影显示造影剂灌注持续时间约（4.8±2.4）s，呈整体均匀增强、轮廓清，与相邻正常甲状腺实质比较呈等增强。⑤术中未使用超声检测者有6例术后发生甲状旁腺功能低下，术中使用超声检测者仅2例，差异有统计学意义（P＜0.05）。结论 正常甲状旁腺超声多表现为椭圆形高回声及稍高回声小结，位于甲状腺下极附近居多，其内可探及血流信号，超声造影表现为均匀等灌注，弹性成像表现为较甲状腺硬度稍软。甲状腺全切除者术中使用超声检测可降低术后甲状旁腺功能低下的发生率。 |
| 关键词: 超声检查 造影剂 弹性成像 甲状旁腺 甲状腺切除 甲状旁腺素 |
| DOI： |
| 投稿时间：2018-09-15修订日期：2019-06-07 |
| 基金项目:石家庄市科学技术研究与发展指导计划（第一批） 项目编号：181460443 |
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| The Location And Characteristics of Normal Parathyroid Ultrasound Images |
| zhangjunhua |
| () |
| Abstract: |
| Objective to explore the imaging characteristics and display location of normal parathyroid gland in high frequency ultrasound, color and energy doppler ultrasound, ultrasound elasticity examination, and contrast-enhanced ultrasound, so as to provide guidance for the protection of normal parathyroid gland in clinical thyroidectomy. Methods select 220 cases of normal adults and 60 cases of merger to total excision of the thyroid gland, thyroid gland tumor all parathyroid ultrasonographic examination, location markers on the basis of the thyroid gland, line of high frequency ultrasound and color doppler ultrasound examination, energy and 50 cases of normal adult line ultrasonic elasticity to check at the same time, 20 cases of normal adult the contrast-enhanced ultrasound examination at the same time, the analysis summary of normal parathyroid ultrasonic image characteristics and location. The 60 cases of total thyroidectomy were divided into 30 cases of intraoperative ultrasonic examination and 30 cases of non-ultrasonic examination to compare the incidence of postoperative parathyroid dysfunction. Results ①there were 217 cases of parathyroid gland in 280 cases, and the high frequency ultrasound display rate was 77.5% (217/280). A total of 412 parathyroid glands were found, 36 (8.7%) located behind the upper thyroid pole, 138 (33.5%) behind the body, 179 (43.5%) behind the lower thyroid pole, and 59 (14.3%) within 2 cm below the lateral lobe. ②color and energy doppler ultrasound can display 301 blood flow signals (73.0%). ③the elastic value of 50 normal parathyroid glands measured by ultrasonography was (12.3±2.1) kPa, and the elastic value of adjacent normal thyroid gland was (27.2±2.5) kPa, the difference was statistically significant (P<0.05). ④contrast-enhanced ultrasonography of 20 normal parathyroid glands showed that the duration of contrast agent perfusion was about (4.8±2.4) s, with overall uniform enhancement and clear contour, and equal enhancement compared with adjacent normal thyroid parenchyma. ⑤there were 6 cases of low parathyroid function in patients without ultrasonic examination during the operation, and only 2 cases of patients with ultrasonic examination during the operation, the difference was statistically significant (P < 0.05). Conclusion the normal parathyroid ultrasonography usually presents elliptic hyperechoic and slightly hyperechoic nodules, which are mostly located near the lower pole of the thyroid gland, and can detect blood flow signals in the thyroid gland. The use of ultrasound in total thyroidectomy can reduce the incidence of postoperative parathyroid dysfunction. |
| Key words: Ultrasonic examination Parathyroid gland Thyroidectomy Elastic imaging Contrast - enhanced ultrasound parathyroid hormone |
