The Role of Surgeon-Performed Office and Preincision Ultrasounds in Localization of Parathyroid Adenomas in Primary Hyperparathyroidism

被引:1
|
作者
Choi, Jee-Hye [1 ]
Jayaram, Anusha [1 ,2 ]
Bresnahan, Erin [1 ,3 ]
Pletcher, Eric [1 ]
Steinmetz, David [1 ]
Owen, Randall [1 ]
Inabnet, William, III [1 ,4 ]
Fernandez-Ranvier, Gustavo [1 ]
Taye, Aida [1 ]
机构
[1] Mt Sinai Hlth Syst, Dept Surg, Icahn Sch Med Mt Sinai, New York, NY 10019 USA
[2] Tufts Univ, Sch Med, Boston, MA USA
[3] New York Univ, Dept Surg, NYU Langone Hlth, Sch Med, New York, NY USA
[4] Univ Kentucky, Dept Surg, UK HealthCare, Coll Med, Lexington, KY USA
关键词
surgeon -performed neck ultrasound; of fice ultrasound; preincision ultrasound; parathyroidectomy; primary hyperparathyroidism; MINIMALLY INVASIVE PARATHYROIDECTOMY; PREOPERATIVE LOCALIZATION; NECK EXPLORATION; HORMONE ASSAY; ULTRASONOGRAPHY; DISEASE; MANAGEMENT;
D O I
10.1016/j.eprac.2022.03.018
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: We studied the use of surgeon-performed office ultrasound (OU) and preincision ultrasound (PIU) in preoperatively localizing parathyroid adenomas in primary hyperparathyroidism (PHPT). Methods: A retrospective chart review was performed for patients with PHPT who underwent para-thyroidectomy between 2013 and 2015. The results of OU and PIU were recorded and compared with the final surgical pathology. Results: Of 348 patients with PHPT, 285 (81.9%) had single-lesion disease, 49 (14.1%) had double-lesion disease, and 14 (4.0%) had multigland disease with 3 or more lesions. For single-lesion disease, the overall sensitivity and specificity of OU to correctly lateralize the lesion were 64.2% and 91.2%, while those of PIU were 89.4% and 93.6%, respectively. The sensitivity and specificity of PIU were comparable to those of 4-dimensional computed tomography (87.1% and 90.7%, respectively) and 99mTc-sestamibi scintigraphy (70.4% and 95.9%, respectively). While the majority of PIU cases were preceded by other imaging studies, the accuracy in localizing lesions was not largely affected by the presence of prior computed tomography and/or 99mTc-sestamibi scintigraphy, as opposed to ultrasounds only. For detecting the presence of multigland disease, the sensitivity and specificity of OU were 26% and 92.2%, while those of PIU were 64.3% and 94.7%, respectively. Conclusion: Surgeon-performed OU and PIU are valuable tools in preoperatively localizing the para-thyroid adenoma in single-lesion disease, while their utility may be limited for double-lesion or mul-tigland disease. PIU in particular yields high accuracy in detecting parathyroid lesions in combination with other imaging modalities. (C) 2022 AACE. Published by Elsevier Inc. All rights reserved.
引用
收藏
页码:660 / 666
页数:7
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