甲状腺旁腺是重要的内分泌腺，维持钙和磷代谢，甲状腺癌手术期间易受到意外损伤。这项回顾性研究旨在调查高频超声成像术对甲状腺癌患者术前解剖定位甲状旁腺的应用，并分析该技术对保护甲状旁腺和减少术后并发症的影响。我们共纳入了165例在我院接受甲状腺癌手术的患者，根据手术时间分为两组：对照组（2018年5月至2021年2月，未应用超声定位技术）和超声定位组（2021年3月至2022年5月）。在超声定位组，术前使用超声确定双侧甲状旁腺的大小和位置，帮助外科医生在手术过程中识别和保护甲状旁腺。我们比较了术前超声与术中观察结果，还测量了两组患者术前和术后第一天的血清钙和PTH值。 我们的术前甲状旁腺超声识别技术与术中观察相比，具有90％以上的准确率（真阳性率）来确定甲状旁腺的位置。术后生化结果显示，与对照组相比，超声定位组的术后第一天血钙[2.12（0.17）vs. 2.05（0.31），P = 0.03]和PTH[27.48（14.88）vs.23.27（16.58），P = 0.005]水平更好。我们还发现，对照组术后至少出现一种甲状旁腺功能减退的风险降低：26例（31.0％）vs. 41例（50.6％），p = 0.016。 超声定位技术可以帮助定位、识别和保护甲状旁腺，在甲状腺切除术中有效降低甲状旁腺功能减退的风险。 版权所有©2023 Chen、Zhang、Liu、Guo、Liu和Geng。

The parathyroid glands are important endocrine glands for maintaining calcium and phosphorus metabolism, and they are vulnerable to accidental injuries during thyroid cancer surgery. The aim of this retrospective study was to investigate the application of high-frequency ultrasound imaging for preoperative anatomical localization of the parathyroid glands in patients with thyroid cancer and to analyze the protective effect of this technique on the parathyroid glands and its effect on reducing postoperative complications.A total of 165 patients who were operated for thyroid cancer in our hospital were included. The patients were assigned into two groups according to the time period of surgery: Control group, May 2018 to February 2021 (before the application of ultrasound localization of parathyroid in our hospital); PUS group, March 2021 to May 2022. In PUS group, preoperative ultrasound was used to determine the size and location of bilateral inferior parathyroid glands to help surgeons identify and protect the parathyroid glands during operation. We compared the preoperative ultrasound results with the intraoperative observations. Preoperative and first day postoperative serum calcium and PTH were measured in both groups.Our preoperative parathyroid ultrasound identification technique has more than 90% accuracy (true positive rate) to confirm the location of parathyroid gland compared to intraoperative observations. Postoperative biochemical results showed a better Ca2+ [2.12(0.17) vs. 2.05(0.31), P=0.03] and PTH [27.48(14.88) vs. 23.27(16.58), P=0.005] levels at first day post-operation in PUS group compared to control group. We also found a reduced risk of at least one type of hypoparathyroidism after surgery in control group:26 cases (31.0%) vs. 41 cases (50.6%), p=0.016.Ultrasound localization of the parathyroid glands can help in the localization, identification and in situ preservation of the parathyroid glands during thyroidectomy. It can effectively reduce the risk of hypoparathyroidism after thyroid surgery.Copyright © 2023 Chen, Zhang, Liu, Guo, Liu and Geng.