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副甲狀腺腺瘤之超音波表徵
Ultrasonographic Features of Parathyroid Adenoma
摘要
副甲狀腺腺瘤係造成副甲狀腺功能亢進常見的原因之一，通常病灶很小時即發生明顯症狀，而且理學檢查上也不易查覺。超音波掃描由於操作簡便，且無放射線危害，很適合各部位篩檢使用，尤其高頻率之小部位超音波儀，對表淺病灶具有非常好的解析能力，已成爲很重要之副甲狀腺病變篩檢工具。臺中榮民總醫院自民國74年1月至79年9月止，共有10例副甲狀腺功能過高，經開刀證實爲副甲狀月泉腺瘤病人，此10例於開刀前均接受頸部高頻率超音波掃描，10例中，有8例可由超音波圖像見到甲狀腺體後方的腫瘤，另2例則無法找到病灶，其中1例爲合併甲狀腺腫，無法分辨出副甲狀腺腺瘤；另1例爲縱膈腔內之胸腺旁副甲狀腺腺瘤。至於腺瘤位置，10例中有8例長在下部腺體，2例長在上部腺體。分析此8例副甲狀腺腺瘤之超音波圖型有二：第一型爲均勻低回音結構，共5例，其平均大小爲10.4mm，第二型爲具低回音外環之結構，共3例，平均大小爲20.7mm。鑑別診斷包括頸長肌、神經血管束、食道、後突之甲狀腺病灶、及附近腫瘤、淋巴結等。
並列摘要
Parathyroid adenoma is one of the common causes of hyperparathyroidism. In spite of obvious symptoms, it is usually too small to be found physically. Providing excellent resolution, high-frequency sonography has been the first-line diagnostic tool for parathyroid adenoma. We had 10 cases with the symptoms of hyperparathyroidism. All had been pathologically proved to be parathyroid adenoma and had received high-frequency sonography of neck prior to surgery. Eight cases were discovered to have parathyroid adenomas sonographyically. The other two cases were missed sonographically-one was due to concomitant thyroid goiter; and the other was mediastinal perithymic parathyroid adenoma. Eight adenomas were disclosed at the lower gland, and two were at the higher gland. There were two sonographic patterns of parathyroid adenomas: pattern 1, homogeneous hypoechoic lesion, 5 cases, with the average size of 10.4 mm; and pattern 2, hypoechoic lesion with halo-ring, 3 cases, with the average size of 20.7 mm. The differential diagnoses include normal colles longus muscle, minor neuromuscular bundle, esophagus, thyroid lesion with posterior protrusion, and adjacent soft tissue masses or lymphadenopathies.