| 摘要: |
| 目的 以前期筛选出的正常甲状旁腺超声影像特征为基础,进行正常甲状旁腺超声引导下细针穿刺,测定抽吸物甲状旁腺激素(PTH)含量并进行细胞学涂片检查,验证正常甲状旁腺超声影像特征的可靠性。方法 2012年10月至2013年1月,10例健康志愿者在履行自愿、知情、同意的前提下入选本研究。在超声引导下完成正常甲状旁腺声像区、颈部淋巴结声像区的22G细针穿刺,对细针穿刺抽吸物分别制备细胞学涂片和洗脱液。同步采取外周静脉血,将洗脱液和血液标本送检验科行PTH半定量测定。细胞学涂片送病理科检查。结果 10例受试者的正常甲状旁腺声像区和颈淋巴结声像区细针穿刺取材均获成功,细胞学检查均发现有细胞存在,无术中和术后并发症。受试者正常甲状旁腺穿刺物洗脱液中PTH测值232.53~357.38 pg/mL,平均(287.12±35.41) pg/mL；淋巴结穿刺物洗脱液中PTH测值8.67~34.28 pg/mL,平均(16.03±8.47) pg/mL；血液PTH测值32.64~47.85 pg/mL,平均(37.44±7.26) pg/mL。10份甲状旁腺区标本中3份细胞量不足,不能做出判断；另7份标本细胞量充足,其中4份倾向于甲状旁腺来源,3份不能确定。10份淋巴结区标本都能够见到明确的淋巴细胞,淋巴结诊断成立。结论 超声引导下穿刺抽吸物洗脱液PTH测定结果与超声影像上正常甲状旁腺、良性淋巴结具有高度的一致性,初步证实前期筛选出的正常甲状旁腺超声影像特征的可靠性。 |
| 关键词: 甲状旁腺 超声检查 细针穿刺 细胞学诊断 洗脱液 甲状旁腺激素 |
| DOI：10.3724/SP.J.1008.2013.00357 |
| 投稿时间：2013-03-25修订日期：2013-04-01 |
| 基金项目:国家自然科学基金(81171436). |
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| Determination of parathyroid hormone content in ultrasound-guided fine-needle aspiration of normal parathyroid and cytological verification |
| ZHANG Jian-quan*,SHENG Jian-guo,ZHAO Lu-lu,LU Feng |
| (Department of Ultrasound in Medicine, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China) |
| Abstract: |
| Objective To determine the parathyroid hormone (PTH) content in ultrasound-guided fine-needle aspiration sample of normal parathyroid based on ultrasound characteristics previously screened out, so as to verify the reliability of the ultrasound characteristics of normal parathyroid. Methods Between Oct. 2012 and Jan. 2013, 10 healthy volunteers were enrolled in the present study after obtaining written informed consent and approval by the ethics committee of our institution. Ultrasound-guided percutaneous aspiration from both the ultrasonic parathyroid area and well-recognized neck lymph node was conducted by using 22G fine needles. The aspirates were taken for cytology purpose and the washing of the left-over in the canula was taken for PTH evaluation by electrochemiluminescence. Simultaneously samples of venous blood were obtained also for PTH evaluation as controls. Results The aspiration procedures were successfully for all the 10 subjects, and cytological examination all found cells, with no intraoperative or and postoperative complications. PTH level in the washing of left-over extracted from the parathyroid aspirates averaged (287.12±35.41) pg/mL and ranged 232.53-357.38 pg/mL, and that from the lymph node averaged (16.03±8.47) pg/mL and ranged 8.67-34.28 pg/mL; while the serum PTH level averaged (37.44±7.26) pg/mL and ranged 32.64-47.85 pg/mL. Three of the ten aspirates of parathyroid did not have enough cells to make predication, and the other seven aspirates had enough cells, with four likely from parathyroid and three from indefinite origins. All the ten aspirates from the lymph node areas were confirmed to have definite lymphocytes. Conclusion PTH evaluation results by fine-needle washing after ultrasound-guided aspiration are highly consistent with the ultrasonic parathyroids and lymph nodes, which preliminarily proves the reliability of the previously identified ultrasound characteristics of normal parathyroids. |
| Key words: parathyroid ultrasonography fine-needle aspiration cytology washing of left-overs parathyroid hormone |
