Abstract:
PURPOSE:To determine the role of ultrasonography (US) with supplemental computed tomography (CT) in patients with primary hyperparathyroidism who undergo minimally invasive surgery instead of conventional neck exploration. MATERIALS AND METHODS:US and CT were performed in 61 consecutive patients with primary hyperparathyroidism (part 1) to identify and localize solitary adenomas for resection by means of minimally invasive surgery and to provide a surgical road map. In part 2, involving 33 consecutive patients, CT was performed only when no solitary adenoma was identified with US or for road map information. Minimally invasive surgery was considered successful when serum calcium levels normalized and remained stable. RESULTS:In part 1, 46 definite solitary adenomas were found with US and two additional ones with CT. Minimally invasive surgery was successful in 45 patients and failed once. In part 2, US helped identify 23 solitary adenomas, and CT helped to find one. Minimally invasive surgery was successful in 22 patients and failed in two. Combined results in 94 patients demonstrated successful minimally invasive surgery in 67 (71%), with 64 of them selected with US alone (95% CI: 61, 80). The sensitivity of US in the diagnosis of solitary adenoma was 78% (95% CI: 67%, 86%), with a positive predictive value of 96% (95% CI: 88%, 99%). CONCLUSION:US examination of patients with primary hyperparathyroidism allowed successful selection for minimally invasive surgery in more than two-thirds of the cases, with additional CT useful chiefly for surgical road mapping.
journal_name
Radiologyjournal_title
Radiologyauthors
van Dalen A,Smit CP,van Vroonhoven TJ,Burger H,de Lange EEdoi
10.1148/radiol.2203000998subject
Has Abstractpub_date
2001-09-01 00:00:00pages
631-9issue
3eissn
0033-8419issn
1527-1315journal_volume
220pub_type
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