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甲状腺腺瘤对腺体胚胎起源的导向在超声波上
Kyle R Hannabass1,2, Joaquin Austerlitz1,3, Julia E Noel1,4
1Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Stanford, California.
JAMA otolaryngology-- head & neck surgery
|July 18, 2024
概括
超声波 (美国) 可以通过测量腺瘤之间的角度来预测甲状腺腺瘤 (PTA) 的胚胎起源.
科学领域:
- 内分泌学 在内分泌学.
- 手术瘤学手术瘤学
- 诊断成像 诊断成像 诊断成像
背景情况:
- 准确的副甲状腺腺瘤 (PTA) 的术前定位对于初级副甲状腺症的成功向性副甲状腺切除术至关重要.
- 目前的局部化方法可能有局限性,需要改进的技术来预测腺体起源.
研究的目的:
- 为了评估形超声波 (US) 在基于腺瘤长轴和带肌肉之间的角度来预测PTAs的胚胎起源的实用性.
- 评估美国测量的有效性,以指导副甲状腺切除术的外科局部化.
主要方法:
- 使用斯坦福研究库数据进行的诊断研究 (2009年1月-2021年10月).
- 纳入标准:年龄≥18岁的患有原发性副甲状腺功能障碍的患者,对PTA有明确的SAGITTAL US视图,并且在手术内和病理上确认了原发腺.
- 测量PTA的长轴和带肌肉之间的角度在松动脉上;分析PTA和后动脉边界在横向动脉上的关系.
主要成果:
- 在442个腺瘤中,314个具有可测量的角度. 94°的优化角度显示出74%的灵敏度和72%的特异性,用于区分优质和劣质PTA.
- 使用90度的断点,角度分析在确定PTA来源时达到72.9%的准确性.
- 使用后动脉边界的横向美国分析显示,预测腺起源的准确率为66.9%.
结论:
- 对PTAs的SAgittal US角化是预测腺体起源和指导向性甲状腺切除术的宝贵工具.
- 美国对PTA-心动脉关系的横向评估为预测腺起源提供了一种额外的方法.
- 这些基于美国的技术很容易应用,可以补充其他成像模式,以改善外科手术规划.
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