Study of the Ultrasound Appearance of the Normal Parathyroid Using an Intraoperative Procedure

Xia, Chunxia; Zhu, Qiang; Li, Zheng; Hu, Minxia; Fang, Jugao; Yue, Changli; Bai, Yuping

doi:10.1002/jum.14691

Cited by 14 publications

(16 citation statements)

References 19 publications

(31 reference statements)

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“…1). Only a few scholars have reported this manifestation of US previously [18].The sensitivity of this sign in the diagnosis of parathyroid nodules is 63.6%, and it is highly sensitive to parathyroid adenomas with a maximum diameter of ≤ 1.55 cm. However, it is difficult to Fig.…”

Section: Discussionmentioning

confidence: 98%

Efficacy of ultrasonography and Tc-99m MIBI SPECT/CT in preoperative localization of parathyroid adenomas causing primary hyperthyroidism

Zhao

Yin

et al. 2021

BMC Med Imaging

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Background Primary hyperparathyroidism (PHPT) results from an excess of parathyroid hormone (PTH) produced from an overactive parathyroid gland. The study aimed to explore the sonographic features of parathyroid adenomas and assess the diagnostic performance of ultrasonography (US) and Tc-99m MIBI SPECT/CT for preoperative localization of parathyroid adenomas. Methods A total of 107 patients were enrolled in this retrospective study who had PHPT and underwent parathyroidectomy. Of the 107 patients, 97 performed US and Tc-99m MIBI SPECT/CT examinations for preoperative localization of parathyroid nodules. The sensitivity and accuracy of each modality were calculated. Results In this study, residual parathyroid sign and polar vascular sign were identified as characteristic US features of parathyroid adenomas. These manifestations were closely related to the size of the abnormal parathyroid lesions. Among the 108 parathyroid nodules from 97 patients with PHPT, the sensitivity and accuracy of US for locating the parathyroid nodules were significantly higher than those of Tc-99m MIBI SPECT/CT (93.0% vs. 63.0% and 88.0% vs. 63.0% respectively; χ2 = 26.224, 18.227 respectively, P < 0.001). The differences between US + Tc-99m MIBI SPECT/CT and Tc-99m MIBI SPECT/CT-alone were statistically significant (χ2 = 33.410, 21.587 respectively, P < 0.001), yet there were no significant differences in the sensitivity or accuracy between US + Tc-99m MIBI SPECT/CT and US-alone (χ2 = 0.866, 0.187 respectively, P = 0.352 and 0.665). Conclusions US shows significantly better sensitivity and accuracy for localization of parathyroid adenomas than Tc-99m MIBI SPECT/CT. However, US combined with Tc-99m MIBI SPECT/CT is of great clinical value in the preoperative localization of parathyroid nodules in patients with PHPT.

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Section: Discussionmentioning

confidence: 98%

Efficacy of ultrasonography and Tc-99m MIBI SPECT/CT in preoperative localization of parathyroid adenomas causing primary hyperthyroidism

Zhao

Yin

et al. 2021

BMC Med Imaging

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“…Previous work suggested normal parathyroid glands may be hyperechoic and homogeneous on ultrasound, although gland identity was never confirmed by histopathological, biochemical, or fluorescence review. 12 Multiple other studies have concluded ultrasonography to be unreliable for identification of normal parathyroid glands. 3 , 13…”

Section: Discussionmentioning

confidence: 99%

“…11 Previous work suggested normal parathyroid glands may be hyperechoic and homogeneous on ultrasound, although gland identity was never confirmed by histopathological, biochemical, or fluorescence review. 12 Multiple other studies have concluded ultrasonography to be unreliable for identification of normal parathyroid glands. 3,13 Here, however, we report successful identification of normal parathyroid glands using ultrasound, in which they appear as distinct, homogeneously hyperechoic structures in the perithyroidal central neck.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound Identification of Normal Parathyroid Glands

Cohen¹,

Noel²,

Puccinelli³

et al. 2021

OTO Open

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Ultrasound has become indispensable for identification of thyroid and parathyroid pathology, but normal parathyroid glands have historically been considered too subtle to accurately detect. Inability to identify and protect parathyroid glands can result in hypoparathyroidism and hypocalcemia during thyroidectomy surgery as well as misinterpretation of central neck structures in the postoperative neck. Advances in ultrasound resolution have opened the door to novel applications for this technology. In this study, we report the first surgeon-performed ultrasound identification of normal parathyroid glands in a series of 6 patients, confirmed by parathyroid tissue aspirate or parathyroid autofluorescence. Recognition of normal parathyroid glands using ultrasound can be valuable for preventing postoperative hypoparathyroidism and in increasing the accuracy of postsurgical ultrasound surveillance.

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“…Only a few scholars have reported this manifestation of US. [15]The sensitivity of this sign in the diagnosis of parathyroid nodules is 63.6%, and it is highly sensitive to parathyroid adenomas with a maximum diameter of ≤ 1.55 cm. However, it is di cult to nd residual normal glands when the tumor is large, which may be caused by smaller residual normal gland tissue and compression.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Ultrasonography and Tc-99m MIBI SPECT/CT in Preoperative Localization of Parathyroid Adenomas Causing Primary Hyperthyroidism

Zhao

Yin

et al. 2021

Preprint

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Background: Primary hyperparathyroidism (PHPT) results from an excess of parathyroid hormone (PTH) produced from an overactive parathyroid gland. The study aimed to explore the sonographic features of parathyroid adenomas and assess the diagnostic performance of ultrasonography (US) and Tc-99m MIBI SPECT/CT for preoperative localization of parathyroid adenomas. Methods: A total of 107 patients were enrolled in this retrospective study who had PHPT and underwent parathyroidectomy. Of the 107 patients, 97 performed US and Tc-99m MIBI SPECT/CT examinations for preoperative localization of parathyroid nodules. The sensitivity and accuracy of each modality were calculated. Results: In this study, residual parathyroid sign and polar vascular sign were identified as characteristic US features of parathyroid adenomas and these manifestations are closely related to the size of the abnormal parathyroid lesions. Using 108 parathyroid nodules from 97 patients with PHPT, the sensitivity and accuracy of US in locating parathyroid nodules were significantly higher than those of Tc-99m MIBI SPECT/CT (93.0% vs. 63.0% and 88.0% vs. 63.0%), and the difference was statistically significant (c²=26.224, 18.227, P<0.001). The difference between US combined with Tc-99m MIBI SPECT/CT and Tc-99m MIBI SPECT/CT-alone was statistically significant (c²=33.410, 21.587, P<0.001), yet there was no significant difference compared with US alone (c²=0.866, 0.187, P=0.352 and 0.665). Conclusions: US shows significantly better sensitivity and accuracy for localization of parathyroid adenomas than Tc-99m MIBI SPECT/CT. However, US combined with Tc-99m MIBI SPECT/CT is of great clinical value in the preoperative localization of parathyroid nodules in patients with PHPT.

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Study of the Ultrasound Appearance of the Normal Parathyroid Using an Intraoperative Procedure

Abstract: The normal parathyroid had hyperechoic echogenicity on both intraoperative and percutaneous US imaging. Residual tissue of parathyroid glands can also be observed in some parathyroid abnormalities with an echogenic appearance on US imaging and confirmed by histopathologic results.

Cited by 14 publications

References 19 publications

Efficacy of ultrasonography and Tc-99m MIBI SPECT/CT in preoperative localization of parathyroid adenomas causing primary hyperthyroidism

Efficacy of ultrasonography and Tc-99m MIBI SPECT/CT in preoperative localization of parathyroid adenomas causing primary hyperthyroidism

Ultrasound Identification of Normal Parathyroid Glands

Efficacy of Ultrasonography and Tc-99m MIBI SPECT/CT in Preoperative Localization of Parathyroid Adenomas Causing Primary Hyperthyroidism

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