Developmenth of the ultrasound device for thr preoperative lacalization of parathyroid tumor

我们研制了3种机械扇形扫描仪来预测甲状旁腺肿瘤的定位：I型、II型和III型均为7.5 MHz，III型为10 MHz。I型为2cN焦距，水囊位于扫描头。II型包括3 cm的焦距和聚乙烯突出的扫描头。III型(10 MHz)与水囊扫描仪的焦距为1 cm。所有扫描仪均配备超声实时引导系统(ALOKA SSD-125R)。对6例原发性甲状旁腺功能亢进症(PHP)和4例继发性甲状旁腺功能亢进症(SHP)患者进行了超声检查。在这些SACES中，还进行了计算机断层扫描(CT)和核素扫描(201&gt；TL)。在3种类型的扫描仪中，以II型为主，因为这种类型的扫描仪图像最清晰，操作方便。与传统的5 MHz电子实时线阵扫描仪相比，TYPELE对甲状旁腺病变的显示更清晰，能发现较小的甲状旁腺细胞瘤或增生性病变，并与手术结果对照，评价超声、CT和RI对甲状旁腺病变的预测性。对6例甲状旁腺腺瘤和14例肥大的甲状旁腺腺体进行了术前定位检查。4例重量在0.5g以下的甲状旁腺，超声诊断准确率为75%，CT诊断准确率为50%，RI未检出甲状旁腺。对6个0.5~1.0g的甲状旁腺病变，超声、CT和RI的诊断准确率分别为50%、17%和33%。对10个大于1.0 g的甲状旁腺病变，超声、CT和RI的诊断准确率分别为90%、70%和70%。US的总体敏感性高于CT和RI。超声、CT和RI可检出甲状旁腺的最小重量分别为150 mg、150 mg和500 mg，术中超声未能清楚显示甲状旁腺的情况。同样，美国指导下的经皮甲状旁腺立体视手术也未获成功。

We developed 3 types of mechanical sector scamer to predict the localization of parathyorid tumor:type I, II and III. Both of type and II are 7.5 MHz scanners;typeIII 10 MHz scanner. Type I had a 2 cn focal distance with water bag at the scanhead. The typeII consisted of a 3 cm focal distance and polyethylen protruding scanhead. On the other hand, the focal distance of typeIII (10 MHz) with water bag scanheas was 1 cm.All scanners were equiped with the ultrasonic real-time guidance system(Aloka SSD-125^r). Ultrasonographic investigations were performed in 6 cases of primary hyperparathyroidism (PHP) and 4 parients with secondary hyperparathyroidism (SHP). In these saces, computed tomography (CT) and scintigraphy(^<201> TL) were carried out,too.Among 3 types of scanner,typeII was mainly used,since this type gave the most clear picture and typell was operated easily. TypeII was namely the bast.Compared with conventinal electronic real-time linear scanner of 5 MHz,typell depicted more clearly abnormal parathyroid glands and could detect smaller senoma or hyperplasia.The predictability by ultrasonography (US),CT and RI was evaluated compared with operative findings,respctively. The preoperative localization of 6 parathyoid adenomas and 14 hypertrophied parathyroid glands were examined. In 4 parathyroid gland under 0.5g of weighr, the diagnostic accuracy of US was 75%, while that of CT was 50% and no gland was detected by RI. In 6 parathyroid gland from 0.5g to 1.0g the predictability was 50% by US,17%by CT and 33% by RI.As to 10 parathroid gland over 1.0g, the diagnotsic accuracy of US,CT,and RI was 90%,70%and 70%, respectively. US had the higher overall sensitivity than CT and RI. The minimum weight of the detectable parathyroid gland was 150mg,150mg and 500mg by US,CT and RI,respctively.Ultrasonography during the operation did not give the picture of parathyroid gland clearly. Similarly,the percutaneoud parathyroid diopsy guided by US was not successful.