■超声(US)是检测甲状旁腺区域病变的最经济,最广泛使用的方法。确定典型的甲状旁腺腺瘤为边缘清晰的低回声结节。然而,10%的病变表现出非典型特征,如双同心符号,对他们的认知还有待提高。
■促进对具有双同心回声征的甲状旁腺病变的临床和组织病理学特征的理解,并探讨其发病机制和与颈部淋巴结的区分方法,以提高US诊断的准确性。
■回顾,患者分为三组:第1组,36例甲状旁腺病变具有双同心回声征象;第2组,40例患者表现出典型的低回声甲状旁腺病变;第3组,包括36例确定有淋巴结的患者,从2018年1月至2019年12月全部检查。人口统计学的临床数据,临床症状,血清水平,组织病理学发现,并对美国图像特征进行了全面回顾。
■根据临床数据,第1组和第2组的人口统计学或病变大小无显著差异(p>0.05).生化标志物没有显著差异,包括PTH,T-25OHD,ALP。然而,在调整后的血清钙水平上有显著差异,与第2组相比,第1组明显更低(p<0.05)。此外,第1组无症状患者的比例明显高于第2组(p<0.05).病理检查显示,所有具有双同心回声征象的病变均为甲状旁腺腺瘤。等回声中心区域主要对应于疏松水肿区域,而低回声周围层主要与主细胞和/或嗜酸细胞相关。通过比较第1组和第3组的超声检查,具有双同心回声征象的甲状旁腺病变显示出与淋巴结大小的显着差异,血流分类,血管分布,解剖位置(p<0.05)。
■在美国具有双同心回声征象的甲状旁腺病变与患者的特定组织病理学表现和相对温和的临床特征相对应,这一发现可能增加US偶然发现甲状旁腺病变的可能性.注意尺寸的细节,location,和血液流动,尤其是,可以帮助美国医生区分甲状旁腺腺瘤和颈部淋巴结。
UNASSIGNED: Ultrasound (US) is the most economical and widely used method for detecting lesions in parathyroid regions. Identifying typically parathyroid adenomas as hypoechoic nodules with clear margins. However, 10 % of lesions exhibit atypical features, such as the dual concentric sign, and the cognition of them still needs to be improved.
UNASSIGNED: To promote understanding of clinical and histopathological features for parathyroid lesions with the dual concentric echo sign and to investigate its pathogenesis and methods for distinguishing from cervical lymph nodes to improve US diagnostic accuracy.
UNASSIGNED: Retrospectively, patients were categorized into three groups: Group 1, with 36 patients showing parathyroid lesions with dual concentric echo signs; Group 2, with 40 patients displaying classic hypoechoic parathyroid lesions; and Group 3, comprising 36 patients with identified lymph nodes, which were all examined from January 2018 to December 2019. The clinical data on demographics, clinical symptoms, serum levels, histopathologic findings, and US image characteristics were thoroughly reviewed.
UNASSIGNED: According to the clinical data, no significant differences in demographics or lesion sizes were observed in Group 1 and Group 2 (p > 0.05). No significant variances were noted in biochemical markers, including PTH, T-25OHD, and ALP. However, a notable difference was identified in adjusted serum calcium levels, which were significantly lower in Group 1 compared to Group 2 (p < 0.05). Additionally, the proportion of asymptomatic patients was significantly higher in Group 1 compared to Group 2 (p < 0.05). Pathological examination revealed that all lesions with dual concentric echo signs were parathyroid adenomas. The isoechoic central region predominantly corresponded to areas of loose edema, while the hypoechoic peripheral layer was primarily associated with chief and/or oncocytic cells. By comparing the ultrasonography of Groups 1 and 3, the parathyroid lesions with dual concentric echo signs exhibited significant distinctions from lymph nodes in size, blood flow classification, vascular distribution, and anatomical location (p < 0.05).
UNASSIGNED: The parathyroid lesions with dual concentric echo signs in US corresponded to specific histopathological manifestations and relatively mild clinical features in the patients, this finding may increase the likelihood of incidental detection of parathyroid lesions by US. Attention to the details of size, location, and blood flow, especially, may aid US physicians in differentiating parathyroid adenomas from cervical lymph nodes.