بررسي استفاده همزمان از اولتراسونوگرافي و اسكن سستاميبي TC99M در تشخيص قبل از عمل غده ي پاراتيروئيد پركار

Simultaneous Use of Ultrasonography and TC99mSS Scan in the Diagnosis of Hyperparathyroidism Preoperatively

Background and purpose: Nowadays, studies on localizing hyperparathyroidism suggest a replacement of bilateral neck surgery of parathyroid with unilateral exploration. The purpose of this study was to survey the simultaneous use of Ultrasonography (US) and 99TCMSS to localize the hyper function of parathyroid gland preoperatively. Materials and methods: A descriptive, retrospective case-series study was carried out on 25 patients with hyperparathyroidism whose parathyroid adenomas localized by US or "rcMSS and underwent surgery between 1999 and 2009. This study involves a retrospective collection of demographic, biochemical and imaging data as well as pathologic and surgical information. The results of imaging studies were compared with surgical and histological findings. Results: The sensitivity of US and SS were higher for adenomas (53% and 83%) than hyperplastic glands (50% and 66%). The sensitivity and PPV in simultaneous use of US and SS to localize single adenoma were 84% and 100%, respectively. Conclusion: Since even one parathyroid lesion was not solely identified using US, there was not a statistically significant difference on the sensitivity of scintigraphy between 99TCMSS and simultaneous use of US and 99TCMSS (P<0.05). Therefore, 99TCMSS is recommended if parathyroid localization prior to unilateral surgery is required.