甲状旁腺功能亢进病灶可视化和热消融的现代技术

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甲状旁腺病理学在内分泌疾病中居第三位，仅次于糖尿病和甲状腺疾病。 目前，只有两种治疗甲状腺功能亢进的方法被广泛应用于临床：保守的和手术的。然而，最近还出现了基于激光、射频、微波等目标物理效应的跨层热分解（消融）方法，超声波。本综述致力于对甲状腺功能亢进的局部热分解方法的现代武库进行批判性分析。本综述的目的是展示现代无创和微创方法治疗甲状旁腺功能亢进的可能性，同时又不反对手术方法。 该综述包括2012年至2021年期间在谷歌学者（Google Scholar，PubMed）中发现的随机临床研究数据。患者总数-1938人（激光消融216人，射频消融225人，微波消融1467人，高密度超声消融30人）。 获得了热分解方法的适用性标准。建立了治疗甲状腺功能亢进的算法。因此，作为手术干预的替代方法，已经分析了四种现代热破坏病理改变的甲状旁腺方法，每种方法都有优点和缺点，其自身的有效性和安全性。 对现有循证实践的分析表明，最受临床医生欢迎的是微波消融方法，而激光消融是一种更有效的热破坏功能亢进的甲状旁腺的方法。

作者简介

Pavel Rumiantsev

International Medical Center “SOGAZ”

Email: pavelrum@gmail.com
ORCID iD: 0000-0002-7721-634X
SPIN 代码: 7085-7976

MD, Dr. Sci. (Med.)

俄罗斯联邦, 8 Malaya Konyushennaya str., Saint Petersburg, 191186

Aleksandr A. Bubnov

Endocrinology Research Centre; National Research Nuclear University MEPhI (Moscow Engineering Physics Institute)

Email: bubnov96@mail.ru
ORCID iD: 0000-0002-5877-6982
SPIN 代码: 9380-1293

graduate student

俄罗斯联邦, Moscow; Moscow

Mikhail V. Degtyarev

Endocrinology Research Centre

Email: germed@mail.ru
ORCID iD: 0000-0001-5652-2607

MD, radiologist

俄罗斯联邦, Moscow

Konstantin Y. Slushchuk

Endocrinology Research Centre

Email: slashuk911@gmail.com
ORCID iD: 0000-0002-3220-2438

MD, endocrinologist, researcher

俄罗斯联邦, Moscow

Svetlana M. Zakharova

Endocrinology Research Centre

Email: smzakharova@mail.ru
ORCID iD: 0000-0001-6059-2827
SPIN 代码: 9441-4035

MD, Cand. Sci. (Med.)

俄罗斯联邦, Moscow

Dmitriy Y. Agibalov

Endocrinology Research Centre

Email: agibalovd@bk.ru
ORCID iD: 0000-0003-2995-7140

doctor

俄罗斯联邦, Moscow

Viktor Y. Timoshenko

National Research Nuclear University MEPhI (Moscow Engineering Physics Institute); Lomonosov Moscow State University

编辑信件的主要联系方式.
Email: vtimoshe@gmail.com
ORCID iD: 0000-0003-3234-1427
SPIN 代码: 7536-2368

Dr. Sci. (Phys-Math), Professor

俄罗斯联邦, Moscow; Moscow

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补充文件

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1. JATS XML
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2. 图 2甲状旁腺功能亢进的甲状旁腺功能亢进的超声成像：a - 原发性甲状旁腺功能亢进； b - 继发性甲状旁腺功能亢进。

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3. 图 3双同位素闪烁扫描：a - 99mTc-MIBI 闪烁扫描； b - 99mTc-TcO4 闪烁扫描。

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4. 图 4。使用 99mTc-MIBI（technetril）进行放射性核素研究：a - 两相平面闪烁扫描（早期和延迟扫描）：甲状旁腺的形成在右叶（箭头）的投影中可视化，放射性药物的持续积累增加关于延迟扫描； b - 单光子发射计算机断层扫描，结合计算机断层扫描，99mTc-MIBI：在左叶下极（箭头）后面和向下形成甲状旁腺，积累放射性药物。

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5. 图 6。使用多通道伽马探测器 Sentiella-102 (a – c) 和 CrystalCam (d) 获得的图像。

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6. 图 7原发性甲状旁腺功能亢进的激光消融：a - 甲状旁腺腺瘤； b - 两根激光纤维的存在和消融后甲状旁腺区域。

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7. Fig. 8.

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8. 图 1使用替代方法破坏甲状旁腺的出版物动态。

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9. 图 5 甲状旁腺功能亢进症诊断算法

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10. 图 8治疗甲状旁腺功能亢进症的算法。

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11. 图 9甲状旁腺热破坏方法的优点（绿色）和缺点（红色）的简要说明。

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版权所有 © Rumiantsev P., Bubnov A.A., Degtyarev M.V., Slushchuk K.Y., Zakharova S.M., Agibalov D.Y., Timoshenko V.Y., 2021

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