The Value Of Ultrasound In Preoperative Qualitative Localization Diagnosis Of Renal Secondary Hyperparathyroidism

Objective:Secondary hyperparathyroidism?SHPT?is basically ranked top in the severity rank of multiple complications of chronic kidney disease?CKD?,postoperative pathological results are used as the gold standard to evaluate the value of preoperative ultrasound qualitative positioning diagnosis of the patients with renal SHPT.Methods:58patients diagnosed with renal failure and uremia were selected,hemodialysis was performed regularly and combined parathyroid hormone?PTH?increased,ultrasound and radionuclide imaging examines were performed before surgery,all underwent nodular excision of the parathyroid hyperplasia,the results of PTH tests before and after surgery were obtained,and the results of pathological examination were obtained after surgery.Ultrasound examination,radionuclide imaging examination,ultrasound combined radionuclide examination results were compared with pathological results,and the sensitivity,specificity,accuracy,positive predictive values and negative predictive values were obtained respectively,the differences in sensitivity,specificity,accuracy,positive predictive values and negative predictive values of the three kinds of test methods were compared by chi-square test to see if there is statistical significant.Results:The differences in sensitivity,accuracy and negative predictive value of radionuclide imaging,ultrasonography examind and radionuclide imaging combined ultrasonography in the diagnosis of renal SHPT have statistical significant(^?2are 90.5,79.9 and 16.6respectively,all P<0.05),through two-two comparisons?bonferroni method?found that the sensitivity,accuracy and negative predictive values for ultrasound examination,radionuclide imaging combined ultrasonography were superior to radionuclide imaging examination,the differences among the sensitivity,accuracy and the negative predictive values of the ultrasound examination and radionuclide imaging combined ultrasonography have no statistical significant?P>0.05/3?.The differences in the specificity and positive predictive values of the three examination methods have no statistical significant(^?2are2.6 and 2.7,respectively,all P>0.05).IOPTH ratio of 4 of the 58 patients>30%,which was judged to be poor in surgical outcome,and the rest reached the success standard of surgeries.The surgery success rate was 93.1%.Conclusion:For patients with renal SHPT,compared with radionuclide imaging,ultrasound examine has absolute advantage,it can be used as the first choice for clinical screening.