title: "Silent" kidney stones in "asymptomatic" primary hyperparathyroidism-a comparison of multidetector computed tomography and ultrasound.
abstract: OBJECTIVE
  The purpose of this study was to demonstrate the high number of kidney stones in primary hyperparathyroidism (PHPT) and the low number of in fact "asymptomatic" patients.
  
  
  METHODS
  Forty patients with PHPT (28 female, 12 male; median age 58 (range 33-80) years; interquartile range 17 years [51-68]) without known symptoms of kidney stones prospectively underwent multidetector computed tomography (MDCT) and ultrasound (US) examinations of the urinary tract prior to parathyroid surgery. Images were evaluated for the presence and absence of stones, as well as for the number of stones and sizes in the long axis. The MDCT and US examinations were interpreted by two experienced radiologists who were blinded to all clinical and biochemical data. Statistical analysis was performed using the Wilcoxon signed-rank test.
  
  
  RESULTS
  US revealed a total of 4 kidney stones in 4 (10 %) of 40 patients (median size 6.5 mm, interquartile range 11.5 mm). MDCT showed a total of 41 stones (median size was 3 mm, interquartile range 2.25 mm) in 15 (38 %) of 40 patients. The number of kidney stones detected with MDCT was significantly higher compared to US (p = 0.00124).
  
  
  CONCLUSIONS
  MDCT is a highly sensitive method for the detection of "silent" kidney stones in patients with PHPT. By widely applying this method, the number of asymptomatic courses of PHPT may be substantially reduced. MDCT should be used primarily to detect kidney stones in PHPT and to exclude asymptomatic PHPT.
authors.affiliation: Section "Endocrine Surgery", Division of General Surgery, Department of Surgery, Medical University, Währinger Gürtel 18-20, A-1090, Vienna, Austria. andreas.selberherr@meduniwien.ac.at.
authors.forename: Andreas
authors.initials: A
authors.lastname: Selberherr
authors.affiliation: Department of Radiology, Medical University, Währinger Gürtel 18-20, A-1090, Vienna, Austria.
authors.forename: Marcus
authors.initials: M
authors.lastname: Hörmann
authors.affiliation: Section "Endocrine Surgery", Division of General Surgery, Department of Surgery, Medical University, Währinger Gürtel 18-20, A-1090, Vienna, Austria.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Prager
authors.affiliation: Section "Endocrine Surgery", Division of General Surgery, Department of Surgery, Medical University, Währinger Gürtel 18-20, A-1090, Vienna, Austria.
authors.forename: Philipp
authors.initials: P
authors.lastname: Riss
authors.affiliation: Section "Endocrine Surgery", Division of General Surgery, Department of Surgery, Medical University, Währinger Gürtel 18-20, A-1090, Vienna, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Scheuba
authors.affiliation: Section "Endocrine Surgery", Division of General Surgery, Department of Surgery, Medical University, Währinger Gürtel 18-20, A-1090, Vienna, Austria.
authors.forename: Bruno
authors.initials: B
authors.lastname: Niederle
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000150:complications* / Q000000981:diagnostic imaging* / Q000601:surgery; D007669:Kidney Calculi / Q000150:complications* / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D016105:Parathyroidectomy; D011237:Predictive Value of Tests; D011446:Prospective Studies; D014463:Ultrasonography
keywords: Asymptomatic hyperparathyroidism; Kidney stones; PHPT; Primary hyperparathyroidism