超声造影评价甲状旁腺自体异位移植成活价值的初步研究

doi:10.11958/20220388

天津医药 ›› 2022, Vol. 50 ›› Issue (9): 980-983.doi: 10.11958/20220388

超声造影评价甲状旁腺自体异位移植成活价值的初步研究

陈丹丹¹^,²(), 万业达³^,^△(), 何辉², 刘妍²

1 天津医科大学研究生院（邮编300070）
2 中国人民解放军联勤保障部队第九八三医院超声诊断科
3 天津市天津医院放射一科

收稿日期:2022-03-16 修回日期:2022-05-15 出版日期:2022-09-15 发布日期:2022-09-05
通讯作者: 万业达 E-mail:chendandan_1986@163.com;yd_wan@sina.com
作者简介:陈丹丹（1986）,女,主治医师,主要从事甲状腺及甲状旁腺疾病超声诊断方面研究。E-mail： chendandan_1986@163.com

Preliminary research of contrast enhanced ultrasound in evaluating the survival value of allotopic autotransplantation

CHEN Dandan¹^,²(), WAN Yeda³^,^△(), HE Hui², LIU Yan²

1 Graduate School of Tianjin Medical University, Tianjin 300070, China
2 Department of Ultrasonic Diagnosis, the People's Liberation Army Joint Logistic Support Force 983 Hospital
3 Department of Radiology I, Tianjin Hospital

Received:2022-03-16 Revised:2022-05-15 Published:2022-09-15 Online:2022-09-05
Contact: WAN Yeda E-mail:chendandan_1986@163.com;yd_wan@sina.com

陈丹丹, 万业达, 何辉, 刘妍. 超声造影评价甲状旁腺自体异位移植成活价值的初步研究[J]. 天津医药, 2022, 50(9): 980-983.

CHEN Dandan, WAN Yeda, HE Hui, LIU Yan. Preliminary research of contrast enhanced ultrasound in evaluating the survival value of allotopic autotransplantation[J]. Tianjin Medical Journal, 2022, 50(9): 980-983.

摘要/Abstract

摘要：

目的探讨超声造影判定甲状旁腺切除术加自体甲状旁腺异位移植术后移植物是否成活的价值。方法收集因肾功能衰竭并发继发性甲状旁腺功能亢进而行甲状旁腺自体异位移植术的患者17例。每例患者于未行动静脉造瘘术的前臂皮下与脂肪之间移植4枚甲状旁腺组织,共68枚。在移植术后15~21 d进行超声造影检查,观察移植物的血供强化情况,估测移植后的甲状旁腺是否成活并具有分泌功能。按照移植物是否全部出现强化表现分为部分移植成功组与全部移植成功组,并以术后30 d双侧头静脉甲状旁腺激素水平对比判定移植物是否成活。结果 17例患者中,全部移植成功组8例,部分移植成功组9例,移植侧头静脉甲状旁腺激素水平高于非移植侧,全部移植成功组头静脉甲状旁腺激素水平高于部分移植成功组,差异有统计学意义（P<0.05）。结论超声造影可以更准确、更有针对性及更早期地评价甲状旁腺自体异位移植的成活率。

关键词: 超声检查,多普勒,彩色, 造影剂, 甲状旁腺, 甲状旁腺功能亢进症,继发性, 移植,自体, 超声造影, 成活率

Abstract:

Objective To investigate the value of contrast enhanced ultrasound (CEUS) in determining graft survival after parathyroidectomy and autologous parathyroid ectopic transplantation. Methods Seventeen patients with renal failure complicated by secondary hyperparathyroidism underwent autotransplantation of parathyroid gland were collected. In each case, 4 parathyroid tissues (68 in total) were transplanted between subcutaneous and adipose tissue of the forearm without venostomy. CEUS was performed 15-21 days after transplantation to observe the enhancement of blood supply of the graft and to estimate whether the parathyroid gland survived and had secretory function after transplantation. According to whether all the grafts showed enhancement, the grafts were divided into the partial successful group and the all successful group. The survival of the grafts was determined by comparing the parathyroid hormone (PTH) levels of bilateral cephalic veins 30 days after surgery. Results Among the 17 patients, there were 8 patients in the all successful group and 9 patients in the partial successful group. PTH levels were higher in the cephalic vein of the transplanted side than those of the non-transplanted side. The levels of PTH in the cephalic vein were significantly higher in the all successful group than those in the partial successful group (P<0.05). Conclusion CEUS can assess the survival rate of parathyroidectomy and autotransplantation more accurately and specifically at an earlier stage.

Key words: ultrasonography,doppler,color, contrast media, parathyroid glands, hyperparathyroidism,secondary, transplantation,autologous, contrast enhanced ultrasound, rate of survival

中图分类号:

R445.1

图/表 2

图1 超声造影下移植后甲状旁腺内的细线状及点状强化前臂皮下的移植后甲状旁腺组织在超声造影下的图像,左侧为造影图像,右侧为常规超声图像,两者可同步观察。左侧箭头所指低回声区为移植后甲状旁腺的二维超声图像,右侧箭头指向处即为移植后甲状旁腺内的线样强化的超声造影图像。

Fig.1 Point-like and line-like enhancement in the parathyroid gland after transplantation observed by contrast-enhanced ultrasound

表1 2组移植侧与非移植侧甲状旁腺激素水平比较（ng/L,$\bar{x}±s$）

Tab.1 Comparison of parathyroid hormone levels between the transplanted group and the non-transplanted group

组别	n	移植侧	非移植侧	t
全部移植成功组	8	93.188±49.042	17.436±7.053	4.324^＊＊
部分移植成功组	9	31.163±7.798	9.778±3.413	7.537^＊＊
t		3.756^＊＊	2.794^＊

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超声造影评价甲状旁腺自体异位移植成活价值的初步研究

Preliminary research of contrast enhanced ultrasound in evaluating the survival value of allotopic autotransplantation

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