Wang Man, Wang Yun, Zhang Zhu-Hua, S U Tong, Chen Yu, Jin Zheng-Yu
{"title":"原发性甲状旁腺功能亢进术前定位的四维CT诊断价值。","authors":"Wang Man, Wang Yun, Zhang Zhu-Hua, S U Tong, Chen Yu, Jin Zheng-Yu","doi":"10.3881/j.issn.1000-503X.16069","DOIUrl":null,"url":null,"abstract":"<p><p>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 preoperative 4D-CT and surgical localization in the following regions:around the upper pole of the thyroid(<i>χ<sup>2</sup></i>=0.500,<i>P</i>=0.480),posterior to the mid-thyroid(<i>χ<sup>2</sup></i><0.001,<i>P</i>>0.999),posterior to the lower pole of the thyroid and the tracheoesophageal groove(<i>χ<sup>2</sup></i>=0.571,<i>P</i>=0.450),below the lower pole of the thyroid and the suprasternal fossa(<i>χ<sup>2</sup></i><0.001,<i>P</i>>0.999),retrosternal anterior mediastinum(<i>χ<sup>2</sup></i><0.001,<i>P</i>>0.999),and other rare locations(<i>χ<sup>2</sup></i><0.001,<i>P</i>>0.999).The preoperative 4D-CT diagnosis of PHPT lesions demonstrated 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 demonstrates good diagnostic efficacy in the preoperative localization of PHPT.</p>","PeriodicalId":6919,"journal":{"name":"中国医学科学院学报","volume":"47 1","pages":"42-47"},"PeriodicalIF":0.0000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Diagnostic Performance of Four-Dimensional CT in Preoperative Localization of Primary Hyperparathyroidism.\",\"authors\":\"Wang Man, Wang Yun, Zhang Zhu-Hua, S U Tong, Chen Yu, Jin Zheng-Yu\",\"doi\":\"10.3881/j.issn.1000-503X.16069\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>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 preoperative 4D-CT and surgical localization in the following regions:around the upper pole of the thyroid(<i>χ<sup>2</sup></i>=0.500,<i>P</i>=0.480),posterior to the mid-thyroid(<i>χ<sup>2</sup></i><0.001,<i>P</i>>0.999),posterior to the lower pole of the thyroid and the tracheoesophageal groove(<i>χ<sup>2</sup></i>=0.571,<i>P</i>=0.450),below the lower pole of the thyroid and the suprasternal fossa(<i>χ<sup>2</sup></i><0.001,<i>P</i>>0.999),retrosternal anterior mediastinum(<i>χ<sup>2</sup></i><0.001,<i>P</i>>0.999),and other rare locations(<i>χ<sup>2</sup></i><0.001,<i>P</i>>0.999).The preoperative 4D-CT diagnosis of PHPT lesions demonstrated 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 demonstrates good diagnostic efficacy in the preoperative localization of PHPT.</p>\",\"PeriodicalId\":6919,\"journal\":{\"name\":\"中国医学科学院学报\",\"volume\":\"47 1\",\"pages\":\"42-47\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"中国医学科学院学报\",\"FirstCategoryId\":\"1087\",\"ListUrlMain\":\"https://doi.org/10.3881/j.issn.1000-503X.16069\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"中国医学科学院学报","FirstCategoryId":"1087","ListUrlMain":"https://doi.org/10.3881/j.issn.1000-503X.16069","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
Diagnostic Performance of Four-Dimensional CT in Preoperative Localization of Primary Hyperparathyroidism.
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 preoperative 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 demonstrated 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 demonstrates good diagnostic efficacy in the preoperative localization of PHPT.
期刊介绍：
Acta Academiae Medicinae Sinicae was founded in February 1979. It is a comprehensive medical academic journal published in China and abroad, supervised by the Ministry of Health of the People's Republic of China and sponsored by the Chinese Academy of Medical Sciences and Peking Union Medical College.
The journal mainly reports the latest research results, work progress and dynamics in the fields of basic medicine, clinical medicine, pharmacy, preventive medicine, biomedicine, medical teaching and research, aiming to promote the exchange of medical information and improve the academic level of medicine. At present, the journal has been included in 10 famous foreign retrieval systems and their databases [Medline (PubMed online version), Elsevier, EMBASE, CA, WPRIM, ExtraMED, IC, JST, UPD and EBSCO-ASP]; and has been included in important domestic retrieval systems and databases [China Science Citation Database (Documentation and Information Center of the Chinese Academy of Sciences), China Core Journals Overview (Peking University Library), China Science and Technology Paper Statistical Source Database (China Science and Technology Core Journals) (China Institute of Scientific and Technological Information), China Science and Technology Journal Paper and Citation Database (China Institute of Scientific and Technological Information)].
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