Purpose: The purpose of our study was to assess the role of ultrasonography (US) before surgical treatment of primary hyperparathyroidism. Materials and methods: We retrospectively evaluated 77 patients (60 women, 17 men; mean age 59 years) with primary hyperparathyroidism who underwent parathyroid US prior to surgery. Sixty-five of 77 (84%) patients had undergone 99mTc- sestamibi (MIBI) scintigraphy. The results were correlated with the surgical and histopathological findings. Results: Surgery revealed 85 abnormal parathyroid glands in 77 patients (70 adenomas, 15 hyperplasias). The locations of the parathyroid glands were typical cervical (n=77), thyrothymic ligament (n=3), carotid sheath (n=2), and mediastinum (n=3). In two patients, intrathyroid microadenoma was diagnosed by histopathology. Seventyfour enlarged glands in 64 patients were correctly identified at US. Per-patient sensitivity and positive predictive values, respectively, were 84% (64/76) and 99% (64/65) for US, 68% (44/65) and 100% (44/44) for scintigraphy and 91% (59/65) and 98% (59/60) for both techniques combined. We weighed 63 out of 85 glands, obtaining a value of 1,004±1,564 mg; 460 mg (mean±standard deviation; median). Conclusions: Preoperative detection and localisation of enlarged parathyroid glands can be based on US, an inexpensive and widely available method, limiting the use of scintigraphy to those cases with negative and/or doubtful findings on US.

Primary hyperparathyroidism : can ultrasonography be the only preoperative diagnostic procedure? / S. Tresoldi, G. Pompili, R. Maiolino, N. Flor, L. De Pasquale, A.A. Bastagli, F. Sardanelli, G. Cornalba. - In: LA RADIOLOGIA MEDICA. - ISSN 0033-8362. - 114:7(2009), pp. 1159-1172.

Primary hyperparathyroidism : can ultrasonography be the only preoperative diagnostic procedure?

R. Maiolino;A.A. Bastagli;F. Sardanelli
Penultimo
;
G. Cornalba
Ultimo
2009

Abstract

Purpose: The purpose of our study was to assess the role of ultrasonography (US) before surgical treatment of primary hyperparathyroidism. Materials and methods: We retrospectively evaluated 77 patients (60 women, 17 men; mean age 59 years) with primary hyperparathyroidism who underwent parathyroid US prior to surgery. Sixty-five of 77 (84%) patients had undergone 99mTc- sestamibi (MIBI) scintigraphy. The results were correlated with the surgical and histopathological findings. Results: Surgery revealed 85 abnormal parathyroid glands in 77 patients (70 adenomas, 15 hyperplasias). The locations of the parathyroid glands were typical cervical (n=77), thyrothymic ligament (n=3), carotid sheath (n=2), and mediastinum (n=3). In two patients, intrathyroid microadenoma was diagnosed by histopathology. Seventyfour enlarged glands in 64 patients were correctly identified at US. Per-patient sensitivity and positive predictive values, respectively, were 84% (64/76) and 99% (64/65) for US, 68% (44/65) and 100% (44/44) for scintigraphy and 91% (59/65) and 98% (59/60) for both techniques combined. We weighed 63 out of 85 glands, obtaining a value of 1,004±1,564 mg; 460 mg (mean±standard deviation; median). Conclusions: Preoperative detection and localisation of enlarged parathyroid glands can be based on US, an inexpensive and widely available method, limiting the use of scintigraphy to those cases with negative and/or doubtful findings on US.
Settore MED/18 - Chirurgia Generale
Settore MED/36 - Diagnostica per Immagini e Radioterapia
2009
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/72098
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