中国医学科学院学报2025，Vol.47Issue(1)：42-47,6.DOI:10.3881/j.issn.1000-503X.16069
四维CT在原发性甲状旁腺功能亢进症术前定位中的诊断价值
Diagnostic Performance of Four-Dimensional CT in Preoperative Localization of Primary Hyperparathyroidism
摘要
Abstract
Objective To evaluate the application value of four-dimensional CT(4D-CT)in the preoperative localization of primary hyperparathyroidism(PHPT).Methods A retrospective analysis was conducted on the clinical data and parathyroid 4D-CT images of 63 patients who underwent PHPT surgery at Peking Union Medical College Hospital between April 2020 and April 2023.Based on the clinical experience of the hospital’s surgeons,parathyroid lesions were categorized into six anatomical regions:around the upper pole of the thyroid,posterior to the mid-thyroid,posterior to the lower pole of the thyroid and the tracheoesophageal groove,below the lower pole of the thyroid and the suprasternal fossa,retrosternal anterior mediastinum,and other rare locations.All images were independently analyzed by two experienced radiologists,with discrepancies resolved through discussion led by a senior radiologist.Using pathological results as the gold standard,the accuracy,sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV),Youden index,positive likelihood ratio(PLR),and negative likelihood ratio(NLR)of preoperative 4D-CT in diagnosing PHPT were calculated.Results There were no statistically significant differences between preopera-tive 4D-CT and surgical localization in the following regions:around the upper pole of the thyroid(χ2=0.500,P=0.480),posterior to the mid-thyroid(χ2<0.001,P>0.999),posterior to the lower pole of the thyroid and the tracheoesophageal groove(χ2=0.571,P=0.450),below the lower pole of the thyroid and the suprasternal fossa(χ2<0.001,P>0.999),retrosternal anterior mediastinum(χ2<0.001,P>0.999),and other rare locations(χ2<0.001,P>0.999).The preoperative 4D-CT diagnosis of PHPT lesions demon-strated a sensitivity of 82.09%,specificity of 97.43%,PPV of 87.30%,NPV of 96.19%,accuracy of 94.71%,Youden index of 79.52%,PLR of 31.94,and NLR of 0.18.Conclusion Parathyroid 4D-CT dem-onstrates good diagnostic efficacy in the preoperative localization of PHPT.关键词
四维CT/原发性甲状旁腺功能亢进症/术前定位检查Key words
four-dimensional CT/primary hyperparathyroidism/preoperative localization分类
医药卫生引用本文复制引用
王曼,王沄,张竹花,苏童,陈钰,金征宇..四维CT在原发性甲状旁腺功能亢进症术前定位中的诊断价值[J].中国医学科学院学报,2025,47(1):42-47,6.基金项目
中央高水平医院临床科研业务费(2022-PUMCH-B-067) （2022-PUMCH-B-067）
