目的:本研究旨在检查正常甲状旁腺(PTGs)的超声(US)特征,这些特征在术前超声检查中被确定,随后在甲状腺手术中被证实。
方法:这项回顾性研究包括161名患者的连续样本(平均值±标准差年龄,56±14岁;128名妇女),在术前USPTG标测中鉴定出294名正常PTG,并在甲状腺切除术中得到证实。美国假定的正常PTG被定义为小的,圆形到椭圆形,颈部中央的高回声结构。这些假定正常的PTG,如术前US所示,被映射到甲状腺计算机断层扫描图像和甲状腺和颈部的图。在术前实时US检查中,位置,尺寸,形状,回声,回声结构,和确定的推测PTG的颗粒内血管流量进行评估。使用广义估计方程方法在上级和下级PTG之间比较了这些特征。
结果:在267(90.8%)正常PTG中观察到了典型的美国特征,即均匀的高回声性,没有腺内血管流动,虽然非典型特征,包括等回声性(1.0%),具有局灶性低回声性的异质回声结构(5.8%),和脑内血管流量(3.7%),在27人中(9.2%)。劣等PTG在后外侧更常见(36.1%vs.5.3%)和甲状腺极位置(29.9%vs.5.3%),在后内侧位置的频率较低(29.2%与88.0%),与优越的PTG相比(每次比较P<0.001)。
结论:大多数正常的PTGs表现出典型的US特征,即无腺内血管血流的均质高回声性。然而,在极少数情况下,正常PTG表现出非典型特征,包括等回声,具有局灶性低回声性的异质回声结构,和腺内血管流动。
OBJECTIVE: This study was performed to examine the ultrasonography (US) features of normal parathyroid glands (PTGs) that were identified on preoperative US and subsequently confirmed during thyroid surgery.
METHODS: This retrospective study included a consecutive sample of 161 patients (mean±standard deviation age, 56±14 years; 128 women) with 294 normal PTGs identified on preoperative US PTG mapping and confirmed during thyroidectomy. A presumed normal PTG on US was defined as a small, round to oval, hyperechoic structure in the central neck. These presumed normal PTGs, as identified on preoperative US, were mapped onto thyroid computed tomography images and diagrams of the thyroid gland and neck. During the preoperative real-time US examinations, the location, size, shape, echogenicity, echotexture, and intraglandular vascular flow of the identified presumed PTGs were assessed. These characteristics were compared between superior and inferior PTGs using the generalized estimating equation method.
RESULTS: The typical US features of homogeneous hyperechogenicity without intraglandular vascular flow were observed in 267 (90.8%) normal PTGs, while atypical features, including isoechogenicity (1.0%), heterogeneous echotexture with focal hypoechogenicity (5.8%), and intraglandular vascular flow (3.7%), were noted in 27 (9.2%). Inferior PTGs were more frequently identified in posterolateral (36.1% vs. 5.3%) and thyroid pole locations (29.9% vs. 5.3%), and less frequently in posteromedial locations (29.2% vs. 88.0%), compared to superior PTGs (P<0.001 for each comparison).
CONCLUSIONS: Most normal PTGs displayed the typical US features of homogeneous hyperechogenicity without intraglandular vascular flow. However, in rare cases, normal PTGs exhibited atypical features, including isoechogenicity, heterogeneous echotexture with focal hypoechogenicity, and intraglandular vascular flow.