| Theme | Hypoparathyroidism and Related Problems in Dialysis Patients | |
|---|---|---|
| Title | Image diagnosis of parathyroid gland | |
| Publish Date | 1997/01 | |
| Author | Yoshihiro Tominaga | Department of Transplant Surgery, Nagoya 2nd Red Cross Hospital |
| Author | Takaharu Nagasaka | 2nd Department of Surgery, Nagoya University |
| Author | Yuji Tanaka | 2nd Department of Surgery, Nagoya University |
| Author | Hiroshi Takagi | 2nd Department of Surgery, Nagoya University |
| [ Summary ] | There are two aims of parathyroid imaging diagnosis. One is to estimate the degree of hyperparathyroidism (HPT) and the other is localization of abnormal parathyroid glands. The first aim can be met by estimating the weight of the parathyroid glands by ultrasonography (US). Glandular weight, estimated preoperatively by ultrasonography, correlated significantly with that measured intraoperatively. When parathyroid glands enlarge to a weight exceeding 500mg, it is possible that these glands are already nodular hyperplastic. Based on histopathological and pathophysiological investigation, it should be born in mind that in such cases HPT may be refractory to medical treatment including vit.D pulse therapy and parathyroidectomy. Since, in renal HPT, all parathyroid glands are fundamentally hyperplastic, it is very helpful to preoperatively recognize the locations of glands, especially ectopic and supernumerary glands by imaging diagnosis. Among the various methods (US, CT, scintigram and MRI) of determining parathyroid localization, all have advantages and disadvantages. The optiomal methods should be selected considering possible locations, especially at reoperation. Recently, reports have appeared in the literature regarding the usefulness of 99mTcMIBI scintigraphy for parathyroid localization. | |