Ultrasound localization of primary hyperparathyroidism:Analysis of missed diagnosis and misdiagnosis
Objective To explore the causes of missed diagnosis and misdiagnosis of ultrasound localization of primary hyperparathyroidism(PHPT).Methods Data of 96 parathyroid lesions in 92 PHPT patients missed diagnosis or misdiagnosed by preoperative ultrasound localization were retrospectively analyzed,and ultrasound manifestations of these lesions were observed.Results Ultrasound missed 64 lesions with a median maximum diameter of 1.3 cm,including 32 lesions in the dorsal region of the thyroid,16 above or below the poles of the thyroid and 16 ectopic lesions.Among 48 missed lesions in the dorsal region of the thyroid,above or below the poles of thyroid,26(26/48,54.17％)had a thickness≤0.5 cm.Ultrasound misdiagnosed 27 lesions as thyroid nodules,with a median maximum diameter of 1.8 cm,including 17 closely adjacent to thyroid,7 incompletely and 3 completely intrathyroid,among which 6 were homogeneously hypoechoic,19 were mixed echogenic and 2 were isoechoic or hyperechoic.Ultrasound misdiagnosed 5 lesions as lymph nodes,with the median maximum diameter of 1.1 cm,including 2 homogeneously hypoechoic and 3 mixed echogenic(2 with peripheral hypoechoic and internal hyperechoic and 1 with peripheral hyperechoic and internal hypoechoic).Conclusion Missed diagnosis and misdiagnosis of ultrasound localization of PHPT were associated with small size,elongated shape and ectopic locations.Attention should be given to differentiating parathyroid lesions with thyroid nodules and lymph nodes.
万方数据
维普
