[Primary hyperparathyroidism: parathyroid scintigraphy and ultrasound in problem patients].
OBJECTIVE
In a retrospective study, the sensitivity of parathyroid scintigraphy and ultrasound was investigated in patients with primary hyperparathyroidism (HPT) with prior histories of surgery of the thyroid or parathyroid (unsuccessful or recidive).


METHODS
Preoperative ultrasound and parathyroid scintigraphy were performed on 65 patients who had had successful surgery and on 12 who had had unsuccessful surgery. The scintigraphy was carried out using a combined double phase/double nuclide technique with 300-600 MBq 99mTc-sestamibi for parathyroid imaging and 80-100 MBq 99mTc-pertechnetate for thyroid imaging.


RESULTS
The sensitivity of parathyroid scintigraphy was 86% in patients with normal thyroid glands, 77% in those with recurrent goiter, and 62% in those with recurrent or persistent HPT. The ultrasound sensitivity was 86%, 50%, and 57% respectively.


CONCLUSIONS
The sensitivity of parathyroid scintigraphy and ultrasound decreases considerably after surgery. That of parathyroid scintigraphy lay significantly below results published to date. However, parathyroid scintigraphy should be performed precisely in these cases, because the number of alternative parathyroid imaging methods aside from ultrasound are limited.
Van De Flierdt
E
E
Radiologie und Nuklearmedizin München. e.van-de-flierdt@radiologie-muenchen.de
Dropmann
A
A
Böck
J
J
Spelsberg
F
F
Fürst
H
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006042:Goiter / Q000601:surgery; D006801:Humans; D006961:Hyperparathyroidism / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010280:Parathyroid Glands / Q000000981:diagnostic imaging* / Q000601:surgery; D011184:Postoperative Period; D011300:Preoperative Care; D012008:Recurrence; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013670:Sodium Pertechnetate Tc 99m; D017256:Technetium Tc 99m Sestamibi; D013961:Thyroid Gland / Q000000981:diagnostic imaging / Q000601:surgery; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon; D014463:Ultrasonography
D017256:Technetium Tc 99m Sestamibi; D013670:Sodium Pertechnetate Tc 99m