M S Weinberger1, K T Robbins. 1. Division of Otolaryngology-Head and Neck Surgery, University of California-San Diego Medical Center.
Abstract
OBJECTIVE: To assess the accuracy of preoperative imaging studies in primary hyperparathyroidism. DESIGN: Retrospective review of all patients treated surgically for primary hyperparathyroidism at The University of California-San Diego Medical Center between January 1990 and May 1992. Results of preoperative imaging studies were compared with surgical and pathologic findings. SETTING: The University of California-San Diego Medical Center, a primary care and referral center. PARTICIPANTS: Twenty-eight patients were included in the study, and a total of 41 imaging studies were obtained. OUTCOME MEASURES: The accuracy of preoperative imaging studies in correctly localizing the site of a parathyroid adenoma. RESULTS: Ultrasound correctly identified the site of a solitary parathyroid adenoma in 82% of cases, and magnetic resonance imaging in 80% of cases. The adenomas that were not localized by ultrasound were correctly localized by magnetic resonance imaging. These findings are discussed within the context of recent trends in parathyroid surgery. CONCLUSIONS: Based on the results and a review of the literature, a simple algorithm for the use of these imaging studies is proposed. Use of this algorithm will improve preoperative planning, and potentially reduce operative time and morbidity.
OBJECTIVE: To assess the accuracy of preoperative imaging studies in primary hyperparathyroidism. DESIGN: Retrospective review of all patients treated surgically for primary hyperparathyroidism at The University of California-San Diego Medical Center between January 1990 and May 1992. Results of preoperative imaging studies were compared with surgical and pathologic findings. SETTING: The University of California-San Diego Medical Center, a primary care and referral center. PARTICIPANTS: Twenty-eight patients were included in the study, and a total of 41 imaging studies were obtained. OUTCOME MEASURES: The accuracy of preoperative imaging studies in correctly localizing the site of a parathyroid adenoma. RESULTS: Ultrasound correctly identified the site of a solitary parathyroid adenoma in 82% of cases, and magnetic resonance imaging in 80% of cases. The adenomas that were not localized by ultrasound were correctly localized by magnetic resonance imaging. These findings are discussed within the context of recent trends in parathyroid surgery. CONCLUSIONS: Based on the results and a review of the literature, a simple algorithm for the use of these imaging studies is proposed. Use of this algorithm will improve preoperative planning, and potentially reduce operative time and morbidity.