Preoperative evaluation of patients with primary hyperparathyroidism: role of high-resolution ultrasound.
Unilateral parathyroid exploration with adenoma removal and identification of a normal parathyroid gland is an accepted surgical approach for the treatment of patients with primary hyperparathyroidism. This study prospectively evaluated the ability of high-resolution sonography to localize adenomas preoperatively and the effect of this localization on operative time and cost in 37 previously untreated patients undergoing surgical treatment for primary hyperparathyroidism. The sensitivity and positive predictive value of the sonographic examination were 84% and 90%, respectively. A true positive sonographic examination decreased surgical time by an average of 40 minutes and reduced operative charges by $564, including the cost of the test ($156). In experienced hands high-resolution sonography can be a cost-effective means of localizing parathyroid adenomas where unilateral exploration is considered an accepted surgical approach.
Koslin
D B
DB
Department of Diagnostic Radiology, Oregon Health Sciences University, Portland 97201, U.S.A.
Adams
J
J
Andersen
P
P
Everts
E
E
Cohen
J
J
D000236:Adenoma / Q000098:blood supply / Q000000981:diagnostic imaging / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D005069:Evaluation Studies as Topic; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D017048:Health Care Costs; D006801:Humans; D006961:Hyperparathyroidism / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009873:Operating Rooms / Q000191:economics; D010280:Parathyroid Glands / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000601:surgery; D010282:Parathyroid Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging / Q000601:surgery; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013997:Time Factors; D018608:Ultrasonography, Doppler / Q000191:economics / Q000379:methods; D018615:Ultrasonography, Doppler, Color / Q000191:economics / Q000379:methods