Preliminary Study Of Preoperative Ultrasound-guided Positive Development Of Parathyroid Localization

Objective:The study is to explore an effective and accurate technique for positive development of parathyroid localization to achieve precise localization before thyroid surgery,to improve the positive rate of parathyroid recognition,effectively protect the parathyroid glands,improve the safety and curative effect of thyroid surgery,and evaluate the efficacy of ultrasonic examination of parathyroid glands.Methods:An ultrasound physician performed an ultrasonography on parathyroid glands in patients who performed thyroid surgery at the head and neck surgery department of Sichuan Cancer Hospital.The ultrasonic condition of parathyroid gland was recorded,including morphology,location and echo,etc.Methylene blue(0.1-0.5 ml)was used to localize the parathyroid gland under ultrasonic guidance with informed consent of patients.Then recorded stained parathyroid glands during operation.The symptoms of hypoparathyroidism,such as numbness of limbs convulsions,and serum parathyroid hormone and calcium were recorded postoperatively.Results:A total of 76 parathyroid glands were detected in 50 patients by ultrasonic examination before thyroid surgery.The detection rate of total parathyroid glands was54.29%(76/140),and that of superior parathyroid gland was 40.00%(28/70).The detection rate of inferior parathyroid gland was 68.57%(48/70).All parathyroid glands showed medium enhanced echo nodules on ultrasonography,Every parathyroid gland was higher echo intensity than thyroid gland.And all parathyroid glands showed clear boundary and uniform echo with the shape of elliptical and round.In our study,33 cases of preoperative parathyroid were located.A total of glands of surgical side were located before operation,and 37 parathyroid glands were stained with the total staining rate of74.0%(37/50).Among them,10 parathyroid glands were proved by intraoperative pathology or the parathyroid hormone test.Transient hypoparathyroidism in 9 of the patients included in this study.Conclusion:Ultrasound can effectively identify normal parathyroid glands,and there is an advantage for the detection of inferior parathyroid gland.The localization of parathyroid gland under the ultrasonic guidance before thyroidectomy has certain clinical feasibility and can be used as an effective method for preoperative localization of parathyroid gland.However,a expansive sample is still needed to prove.