Ultrasonic Diagnosis Value Of Parathyroid Lesions And Comparative Analysis Of Multiple Imaging Modalities

Objective To assess the value of ultrasonography in diagnosing parathyroid lesions，and to analyse different results of multiple imaging modalities in the diagnosis ofparathyroid lesions.Methods104lesions in94patients with parathyroid surgery resection in our hospitalfrom February2009to December2013were analyzed retrospectively. Postoperativepathologic results include85cases of parathyroid adenoma,4cases of hyperplasia,3casesof carcinoma,2cases of parathyroid cyst. All patients underwent ultrasoundexamination.84cases underwent scintigraphy,45cases underwent CT examination.31cases underwent MRI examination.This study analyzed the sonographic characteristics andserum parathyroid hormone levels of different lesions, and the reasons of misdiagnosisand missed diagnosis.It also compared the analysis of multiple imaging modalities.Results Ultrasound could clearly show the size, shape, location, boundary internalecho, blood flow and so on of parathyroid lesion. Different lesions had differentultrasonographic features.It often happened in inferior pole.It was always hypoechoic andrich in blood flow. As the size of parathyroid adenoma increasing, it was susceptible toliquefaction. Parathyroid carcinoma often had calcification. Serum parathyroid hormonelevels of hyperplasia and carcinoma patients increased more obviously. Ultrasoundwere more likely to find the inferior lesions.The causes of misdiagnosis and misseddiagnosis were mainly outburst after thyroid nodules,metastatic lymph nodes andectopic parathyroid lesions.The sensitivity of ultrasonic diagnosis was82.4%，which ishigher than CT and MRI examination.For less than1cm lesions,the sensitivity ofultrasound was obviously higher than other imaging used alone.But for the merger of thyroid nodule lesions, the sensitivity of ultrasound was lower than the nuclear imagingand ultrasound joint nuclear imaging.(all P <0.05).Conclusion Ultrasound had high sensitivity in diagnosing hyperparathyroidism. Itcound be used as the first choice for the diagnosis of hyperparathyroidism. For ectopicparathyroid lesions and the lesions which is merger of outburst after thyroid nodules,ultrasound is not easy to find and distinguish. We can improve the sensitivity ofdiagnosis for disease by jointing multiple imaging modalities,combined with serum PTHand clinical manifestations, which is better for preoperative localization and diagnosis.