Vol.96 No.9 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 96 No.9 September 2003
Accuracy of Preoperative Diagnosis for Primary
Hyperparathyroidism by CT, US and Scintigraphy
Masanobu Imada, Satoshi Nonaka, Tatsuya Hayashi,
Isamu Kunibe and Yasuaki Harabuchi
(Asahikawa Medical College)
We determined the usefulness of computed tomography (CT), ultrasonography (US) and Tc-Tl subtraction scintigraphy for preoperative diagnosis in 12 patients with primary hyperparathyroidism, all of which were solitary adenoma.
Seven (63.6％) of 11 tumors were detected by CT, 7 (58.3％) of 12 tumors were detected by US, and 7 (63.6％) of 11 tumors were detected by Tc-Tl subtraction scintigraphy. Of 7 tumors with size ＞10 mm, 6 (85.7％) were detected by CT, 5 (71.4％) were detected by US, and 6 (85.7％) were detected by Tc-Tl subtraction scintigraphy, whereas only 1 (25％) with a diameter of 10 mm was detected by each of CT or Tc-Tl subtraction scintigraphy and 2 (40％) with diameters 10 mm were detected by US. Of 6 tumors situated behind the thyroid gland or intra thyroid gland, 5 (83.3％) were detected by CT and all 6 (100％) were detected by US, Tl-Tc subtraction scintigraphy, which was employed for 5 tumors, detected all 5 (100％). However, in the tumors situated beneath the thyroid gland only 2 (40％) of 5, 1 (16.7％) of 6 and 2 (33.3％) of 6 were detected by CT, US and Tc-Tl subtraction scintigraphy respectively. In 5 tumors without thyroid disease, 4 (80％) of 5 were detected by both CT and US, 3 (75％) of 4 were detected by Tc-Tl subtraction scintigraphy. However, in 7 tumors with thyroid diseases (papillary carcinoma, follicular carcinoma, follicular adenoma, chronic tyiroiditis, and adenomatous goiter), 3 (50％) of 6 were detected by CT, 3 (42.9％) of 7 were detected by US and 4 (57.1％) of 7 were detected by Tc-Tl subtraction scintigraphy.
Location of tumor was the factor most likely to make appropriate diagnosis difficult for primary hyperparathyroidism by any assessment method.
Key words : primary hyperparathyroidism, parathyroid adenoma, localization study