Iperparatiroidismo primario: è sufficiente l'ecografia come unica indagine diagnostica preoperatoria?

Translated title of the contribution: Primary hyperparathyroidism: Can ultrasonography be the only preoperative diagnostic procedure?

S. Tresoldi, G. Pompili, R. Maiolino, N. Flor, L. De Pasquale, A. Bastagli, F. Sardanelli, G. Cornalba

Research output: Contribution to journalArticlepeer-review

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.

Translated title of the contributionPrimary hyperparathyroidism: Can ultrasonography be the only preoperative diagnostic procedure?
Original languageItalian
Pages (from-to)1159-1172
Number of pages14
JournalRadiologia Medica
Volume114
Issue number7
DOIs
Publication statusPublished - Oct 2009

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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