| Objective:To investigate the diagnostic value of high frequency ultrasound in the normal parathyroid gland, the imaging features and the diagnostic value of the primary parathyroid tumor.Materials and methods:150 patients to hospital examination and thyroid tumor treatment is a normal parathyroid gland, and achieved the 20 pieces of parathyroid pathology results (due to thyroid surgical resection of the parathyroid glands); Analysis ultrasound quasi (80 cases) diagnosed 81 pieces (pathological diagnosis of 78 gold) in patients with primary tumors of the parathyroid. Before surgery all patients had undergone two dimensional and color doppler ultrasonography and serum parathyroid hormone, calcium and phosphorus in check, and obtain all tumor surgery and pathological examination results; Normal parathyroid partition:right district, right lower the district, left district, left under district (double upper district:thyroid edge 0.5cm level to department level, tracheoesophageal groove to the neck total artery outer; lower district:to the thyroid body very 3centimeter below, tracheoesophageal groove to the neck total artery outer and according to each district each display a parathyroid gland as the standard to count the visualization rate of the right, right, left, left area.Results:subjects display 1-4 pieces of normal parathyrord, detected a total ot 546 pieces of normal glands, right area 135 pieces (display rate of 90.0%); right district 140 pieces (display rate of 93.3%); left zone 130 pieces (86.7%), left inferior area of 141 pieces (display rate of 94%), double gland area display rate (93.7%) was higher than that of the double area (88.4%) (P= 0.022). The double bottom zone shows 48 pieces of elliptical body and cable shape,233 in shape,114 in double upper zone and in rope shape, and 151 in irregular shape. Glandular diameter, left-right diameter and anteroposterior size statistical results respectively (millimeter):right upper area 5.99+1.85,3.87+1.10,246+ 0.74; right under Section 701+1.11,4.28+0.63,3.10+0.28; left area of 6.04+1.87,3.70 1.28,2.55+0.67; under the left of the area of 6.97+1.21,4.32+0.67,2.97+0.30, double gland area is double gland area of the diameter larger (t value respectively 3.59,-3.29,-7.41, P less than 0.05 were). The internal parathyroid glands were uniformly high echo 509 (93.2%), and 37 (6.8%) were homogeneous and so on.①81 pieces ultrasonic intended diagnosis of parathyroid tumor and postoperative zoning compliance rate statistics:top right region diagnosed 12 medals, misdiagnosed 2 pieces, in line with the rate of 83.3%(10/12); right lower zone suspected 32 gold coincidence rate 100% (32/32); left area suspected 6 gold,1 was misdiagnosed as gold, in line with the rate of 83.3% (5/6); in the region of the lower left suspected 31 medals in line with the rate of 100% (31/31). The coincidence rate (63/63) was higher than that of the double upper zone (15/18) (P< 0.05).② The 81 rate statistics with ultrasound diagnosed tumors and pathological diagnosis:35 adenoma (upper right area 4, right under the district 12, district 3 on the left, left the area under the 13 gold medal) in line with the rate of 91.4%(32/35), the misdiagnosis rate was 8.6%(3/35),3 were misdiagnosed including nodular goiter (right area 1), thyroid papillary microcarcinoma (upper right 1 pieces), thyroid adenoma (upper left area 1); 5 were adenocarcinoma (upper right, right under the 1 district 2 district,2 district left) with the rate of 100%(5/5); proliferation with cystic 2 (same case right 1, left the area under the district 1) in line with the rate of 100% (2/2); cyst 39 (upper right area 5, right under the district 17, district 2 on the left, left the area under the 15 sold medal) in line with the rate of 100%(39/39). The total coincidence rate of the proposed parathyrord tumor was 96.3%(78/81), and the misdiagnosis rate was 3.7%(3/81).. The coincidence rate of tumor diagnosis in double bottom region (63/63) was higher than that in double upper zone (15/18) (P< 0.05).③in addition to the cyst adenoma, hyperplasia and cancer serum parathyroid hormone showed increased, with cancer increased with, adenoma, and for the corresponding calcium increased and phosphorus decreased. The normal standard value:serum calcium 2.0-2.65mmol/L (Arsenazo Ⅲ method); serum phosphorus 0.8～1.6mmol/L (Ultraviolet direct method); parathyroid hormone 12～65pg/ml (chemiluminescence immunoassay).Conclusion:①the ultrasound has a higher rate of display of parathyroid gland, and the lower zone is more easily than upper area.②The morphology and volume of the parathyroid gland in the double lower zone is more than that of the double upper zone, and the shape of the oval body is more oval. ③Ultrasound is an effective method for diagnosis of primary tumor of the parathyroid gland. |
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