Perioperative localization of ectopic functioning parathyroid gland in patients with hyperparathyroidism
10.3760/cma.j.cn113855-20200527-00424
- VernacularTitle:异位甲状旁腺术前术中定位方法分析
- Author:
Teng ZHAO
1
;
Bojun WEI
;
Xing LIU
;
Hong SHEN
;
Jiacheng WANG
;
Qian WANG
;
Yunhui XIN
Author Information
1. 首都医科大学附属北京朝阳医院甲状腺颈部外科 100020
- Keywords:
Hyperparathyroidism;
Tomography, X-ray computed;
Diagnosis
- From:
Chinese Journal of General Surgery
2021;36(6):446-450
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the value and influence factors of preoperative and intraoperative localization of ectopic hyperparathyroidism (EHPT).Methods:Results of 99mTc-sestamibi ( 99mTc-MIBI), neck ultrasound, contrast CT and intraoperative local venous parathyroid hormone (IOLVPTH) were retrospectively analyzed in 205 patients with primary hyperparathyroidism (PHPT) suspected of EHPT. Results:Incidence of EHPT was 16.6% (34 cases), and 36 ectopic lesions were detected. The proportion of EHPT in antero-superior mediastinum, intrathyroidal, in the retropharyngeal region, in carotid sheath, in the prevertebral region and intrapericardial were 44.1% (15 cases), 29.4% (10 cases), 11.8% (4 cases), 5.9% (2 cases), 5.9% (2 cases) and 2.9% (1 cases), respectively. Contrast CT was the most sensitive (86.1%, 31 lesions/36 lesions) for EHPT, followed by 99mTc-MIBI (66.7%, 24 lesions/36 lesions), IOLVPTH monitoring (61.8%, 21 lesions/34 lesions) and neck ultrasound (55.6%, 20 lesions/36 lesions). Contrast CT was most sensitive,100% in detecting deep-located EHPT lesions, whereas IOLVPTH had advantages in detecting intrathyroidal EHPT lesions, with a sensitivity of 100.0%.The combined use of 99mTc-MIBI and neck ultrasound showed a sensitivity of 77.8% in the localization of EHPT. Conclusions:Contrast CT is highly sensitive in the localization of EHPT. The combined use of preoperative imaging and IOLVPTH monitoring helps to higher localization for EHPT.
