The Clinical Value Of Imaging Examination In Preoperative Diagnosis Of SHPT

Objective: To investigate the value of ultrasonography? CT and MIBI in preoperative diagnosis of secondary hyperparathyroidism,and the surgical treatment of secondary hyperparathyroidism.Methods:Retrospective analysis he imaging data of patients with secondary hyperparathyroidism that were received in our Hospital from January 2012 to December 2016,Combined with postoperative pathology,calculated the sensitivity and specificity of three kinds of imaging examinations and any of the two methods.To analyze the value of the three methods in preoperative diagnosis.Results: There were 48 patients received ultrasonography,138 cases of glands were detected,and 4 patients were not found to increase glands.Surgical examination confirmed that three of the proliferative glands for the false positive,for the two enlarged lymph nodes and a thyroid nodules.2 cases were not detected glandular pathology confirmed by the pathology of 7 hyperplasia of the parathyroid gland,that missed 7.By statistical calculations,the sensitivity of high frequency ultrasound was 77.97% and the specificity was 97.82%.49 patients received CT scan + enhanced examination,a total of 121 cases of glands were detected,Intraoperative pathology confirmed that two of the proliferative glands for the false positive,a swollen lymph nodes and a thyroid nodules.1 case of non-detection of glandular pathology confirmed by the pathology of four hyperparathyroidism,that is,missed 4.By statistical calculations,the sensitivity of CT examination was 66.85% and the specificity was 98.35%.36 patients received 99 m Tc-MIBI examination,a total of 72 cases of glands were detected,Surgical examination confirmed that all the detection of glands are parathyroid hyperplasia tissue,no false positive.1 case of non-detection of glandular pathology confirmed by the pathology of four hyperparathyroidism,that is,missed 4.By statistical calculations,the 99 m Tc-MIBI examination of the sensitivity of 52.56%,specificity of 100%.By statistical analysis,The sensitivity of high frequency ultrasound was better than that of CT(?2 = 5.526,P = 0.019)and 99 m Tc-MIBI(?2 = 6.172,P = 0.013).The sensitivity of CT was higher than 99 m Tc-MIBI(?2= 4.889,P = 0.027).The sensitivity of the combined test was higher than that of the individual examination,the difference was statistically significant,the specificity was not statistically significant;the two pairs of joint examination,high frequency ultrasound + CT(?2 = 4.601,P = 0.032)and high frequency ultrasonography(?2= 18.524,P <0.001),the difference was statistically significant,and the specificity of the three combined methods was similar to that of high-frequency ultrasound + 99 m Tc-MIBI No difference.36 patients received three kinds of examination methods,a total of 130 hypertrophic glands were detected,the sensitivity of 94.89%,specificity of 100%;when its sensitivity and specificity compare with high frequency ultrasound + CT examination,there is no Statistical differences.Conclusion: 1.Recommended high-frequency ultrasound + CT examination as SHPT patients with preoperative positioning diagnosis of the preferred inspection program.2.When the three methods were used alone,the sensitivity of ultrasonography was the highest,and the specificity of 99 m Tc-MIBI was the highest...