Computerized Axial Tomography in the Diagnosis and Management of Thyroid and Parathyroid Disorders

Blum, Manfred; Reede, Deborah L.; Seltzer, Terry F.; Burroughs, Valentine J.; Greene, Loren Wissner; Roses, Daniel F.

doi:10.1097/00000441-198401000-00008

Cited by 13 publications

(2 citation statements)

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“…A wide variety of imaging techniques has been proposed to localize parathyroid adenomata and hyperplasia. Currently, vigorous debate centers on techniques that are readily available, noninvasive, and hold promise as practical methods for parathyroid localization: thallium-technetium scintigraphy (TTS) [5][6][7][8][9][10][11][12][13], computed tomography (CT) [14][15][16][17][18][19][20][21][22][23][24], and sonography (US) [25][26][27][28][29][30][31][32][33][34][35]. We compared these 3 imaging modalities prospectively, using as the standard for comparison the surgical, pathologic, and clinical findings.…”

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Prospective comparison of radionuclide, computed tomographic, and sonographic localization of parathyroid tumors

et al. 1986

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Controversy exists concerning the advantages and appropriateness of current imaging modalities of the localization of parathyroid tumors. We conducted a prospective, blinded study to compare the efficacy of 3 different imaging modalities in 40 patients with primary hyperparathyroidism (HPT). Patients with HPT were examined preoperatively by computer‐assisted thallium‐201/technetium‐99m scintigraphy (TTS), high‐resolution (GE 9800) computed tomography (CT), and high‐resolution (7.5 MHz) real‐time sonography (US). Each study was performed and interpreted independently. These patients then had a neck exploration and parathyroidectomy which allowed for clinical correlation of pathologic findings with the imaging results. Overall sensitivities of the 3 imaging modalities were TTS‐72%, CT‐72%, and US‐57%, with specificities of TTS‐93%, CT‐92%, and US‐96%. For lesions located below the thyroid (thymic tongue and mediastinum), sensitivities were TTS‐86%, CT‐29%, and US‐20%, all with specificities of 100%. In those HPT patients presenting with prior failed neck explorations, parathyroid tumors were detected with sensitivities of TTS‐88%, CT‐57%, and US‐67%, with specificities of 100%, 71%, and 100%, respectively. TTS with subsequent CT appears to be an optimal imaging strategy for HPT patients with prior failed neck explorations or suspected lesions below the thyroid. Since surgeons experienced in parathyroid surgery have a cure rate of 93% or greater in HPT patients without prior neck exploration, these imaging modalities may not be cost‐effective and thus not indicated for these patients.

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Prospective comparison of radionuclide, computed tomographic, and sonographic localization of parathyroid tumors

et al. 1986

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“…To precisely define the gland for clinical purposes, the 1413 79 THYROID IMAGING regional vasculature must be enhanced by the intravenous administration of iodinated contrast material, which is a major limitation to subsequent management when CT is used for thyroid diagnosis. 87,88 If the patient has not had a thyroidectomy, the excessive iodide may cause hyperthyroidism, including cardiac arrhythmias, or may cause hypothyroidism, depending on the underlying thyroid condition. In patients with thyroid cancer who might need a WBS or therapy, the excess iodine will delay diagnosis or therapy.…”

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confidence: 99%

Thyroid Imaging

Blum¹

2016

Endocrinology: Adult and Pediatric

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Amyotrophic Lateral Sclerosis

Mitsumoto

Hanson²,

Chad³

1988

Arch Neurol

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This chapter was originally intended to cover both amyotrophic lateral sclerosis (ALS) and multiple sclerosis, but we will concentrate on ALS. There are nonetheless several reports from the literature that ionotropic glutamate receptor antagonists have beneficial effects in animal models of multiple sclerosis (1,7,14,58,71,109) and this could develop into a very promising therapeutic area in the future. The interested reader is referred to the following review (59). However, the evidence for involvement of disturbances in the glutamatergic system in ALS is already convincing and has led to the use of the glutamate release inhibitor riluzole in the treatment of this disease. As such, we felt that a book on the therapeutic potential of ionotropic glutamate receptor antagonists and modulators would be incomplete without a chapter on this disease. RATIONALEALS, commonly called Lou Gehrig's disease, is a devastating neurological disorder characterized by selective upper and lower somatic, but not autonomic, motor neurone degeneration leading to paralysis and eventually death. The diagnosis of ALS requires the presence of both upper and lower motor neurone degeneration and progressive motor dysfunction. ALS occurs in 1 to 2.5 cases per 100,000 population, affects more men than women, and is most commonly diagnosed in middle age. Other functions such as intellectual abilities and sensory perception are preserved. At advanced stages patients become completely disabled, often requiring ventilatory support and feeding by gas-

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Computerized Axial Tomography in the Diagnosis and Management of Thyroid and Parathyroid Disorders

Cited by 13 publications

References 21 publications

Prospective comparison of radionuclide, computed tomographic, and sonographic localization of parathyroid tumors

Prospective comparison of radionuclide, computed tomographic, and sonographic localization of parathyroid tumors

Thyroid Imaging

Amyotrophic Lateral Sclerosis

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