Contribution of 99mTc-sestamibi scintigraphy by double phase in the exploration of hyperparathyroidism. Report of 20 cases

Introduction. - Tc-99m-sestamibi parathyroid scintigraphy is a means of functional imaging allowing the exploration of hyperparathyroidism. The aim of our study is to demonstrate the utility of double-phase Tc-99m-sestamibi scintigraphy in the exploration of the secreting abnormal parathyroid gland. Materials and methods. - We report, through this work, the observation of 20 patients followed for a biologically ascertained hyperparathyroidism and explored, for the majority of them, by ultrasonography and/or computed tomography. All our patients benefited from a double-phase Tc-99m-sestamibi scintigraphy. Results. - On the 20 studied cases, the sex-ratio was equal to 1, two patients exhibited three high uptake foci at the Tc-99m-sestamibi scintigraphy, six exhibited two foci, twelve exhibited one parathyroid focus. In our series, 80% of patients exhibited secondary hyperparathyroidism and 20% exhibited a primary hyperparathyroidism. The pathologic exam revealed four cases of parathyroid adenoma and 16 parathyroid cases of hyperplasia. Discussion. - The double-phase Tc-99m-sestamibi scintigraphy contributes to the orientation and the improvement of the surgical attitude of the hyperparathyroidism, insofar as it could affirm the multiplicity of some adenomas, the diffuse form of some hyperplasias, and especially ectopic localization of the abnormal parathyroid gland. (c) 2008 Elsevier Masson SAS. All rights reserved.