부갑상선 기능 항진증에서 병변의 영상학적 진단과 위치 탐색 방법의 비교 연구
Comparative Study of Preoperative Imaging Detection and Localization Test for Hyperparathyroidism
1
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
Background and Objectives Accurate preoperative localization of abnormal parathyroid gland is essential for successful parathyroidectomy. The aim of this study was to evaluate the accuracy of a localization test for hyperparathyroidism including ultrasonography (US), computed tomography (CT) and 99mTc-sestamibi scan. Subjects and Method We studied 47 patients with hyperparathyroidism who underwent parathyroidectomy from January 2003 through December 2010, retrospectively. 99mTc-sestamibi scan, US and CT were carried out as a preoperative localization test and their accuracy were analyzed according to the size, location and pathology of parathyroid lesions. Results The accuracy of 99mTc-sestamibi scan, US and CT were 93%, 77% and 65%, respectively. The accuracy of 99mTc-sestamibi scan and CT combined was 94% and US and CT 73%. The accuracy of combination of US and 99mTc-sestamibi scan was 96%, which was not different depending on size, location and pathology of parathyroid lesions. Conclusion The combination of 99mTc-sestamibi scan and US is the most effective method for preoperative detection and the localization of hyperparathyroidism.
Abstract
Background and Objectives Accurate preoperative localization of abnormal parathyroid gland is essential for successful parathyroidectomy. The aim of this study was to evaluate the accuracy of a localization test for hyperparathyroidism including ultrasonography (US), computed tomography (CT) and 99mTc-sestamibi scan. Subjects and Method We studied 47 patients with hyperparathyroidism who underwent parathyroidectomy from January 2003 through December 2010, retrospectively. 99mTc-sestamibi scan, US and CT were carried out as a preoperative localization test and their accuracy were analyzed according to the size, location and pathology of parathyroid lesions. Results The accuracy of 99mTc-sestamibi scan, US and CT were 93%, 77% and 65%, respectively. The accuracy of 99mTc-sestamibi scan and CT combined was 94% and US and CT 73%. The accuracy of combination of US and 99mTc-sestamibi scan was 96%, which was not different depending on size, location and pathology of parathyroid lesions. Conclusion The combination of 99mTc-sestamibi scan and US is the most effective method for preoperative detection and the localization of hyperparathyroidism.
참고문헌 (20)
- Hodin RA, "Detection and management of parathyroid tumors", Curr Opin Oncol, 9(1), pp.75~78 (1997)
- Gluckman JL, "Renewal of certification study group in otolaryngology head and neck surgery", pp.1998, Kendall
- Purcell GP, "Parathyroid localization with high-resolution ultrasound and technetium Tc 99m sestamibi", Arch Surg, 134(8), pp.824~830 (1999)
- Vaid S, "Minimally invasive parathyroidectomy: a community hospital experience", Arch Surg, 146(7), pp.876~878 (2011)
- Norman J, "Minimally invasive parathyroidectomy for primary hyperparathyroidism: decreasing operative time and potential complications while improving cosmetic results", Am Surg, 64(5), pp.391~396 (1998)
- Kaplan EL, "Primary hyperparathyroidism in the 1990s. Choice of surgical procedures for this disease", Ann Surg, 215(4), pp.300~317 (1992)
- Wei JP, "Analysis of savings in operative time for primary hyperparathyroidism using localization with technetium 99m sestamibi scan", Am J Surg, 170(5), pp.488~491 (1995)
- Sfakianakis GN, "Efficient parathyroidectomy guided by SPECT-MIBI and hormonal measurements", J Nucl Med, 37(5), pp.798~804 (1996)
- Derom AF, "Intraoperative identification of parathyroid glands with methylene blue infusion", Am J Surg, 165(3), pp.380~382 (1993)
- Takami H, "Pre-operative localization and tissue uptake study in parathyroid imaging with technetium-99m-sestamibi", Aust N Z J Surg, 69(9), pp.629~631 (1999)
- Irvin GL 3rd, "A new approach to parathyroidectomy", Ann Surg, 219(5), pp.574~581 (1994)
- Khan A, "Preoperative parathyroid localization: prospective evaluation of technetium 99m sestamibi", Otolaryngol Head Neck Surg, 111(4), pp.467~472 (1994)
- McHenry CR, "Parathyroid localization with technetium-99m-sestamibi: a prospective evaluation", J Am Coll Surg, 183(1), pp.25~30 (1996)
- Takami H, "Pre-operative localization and tissue uptake study in parathyroid imaging with technetium-99m-sestamibi", Aust N Z J Surg, 69(9), pp.629~631 (1999)
- Higgins CB, "Role of magnetic resonance imaging in hyperparathyroidism", Radiol Clin North Am, 31(5), pp.1017~1028 (1993)
- Lee VS, "The complementary roles of fast spin-echo MR imaging and double-phase 99m Tc-sestamibi scintigraphy for localization of hyperfunctioning parathyroid glands", AJR Am J Roentgenol, 167(6), pp.1555~1562 (1996)
- Arici C, "Can localization studies be used to direct focused parathyroid operations?", Surgery, 129(6), pp.720~729 (2001)
- 장항석, "최소침습 종양표적하 부갑상선 절제술", 대한외과학회지, 66(06), pp.467~471 (2004), 대한외과학회
- Vaid S, "Minimally invasive parathyroidectomy: a community hospital experience", Arch Surg, 146(7), pp.876~878 (2011)
- Shim YS, "A clinical study of parathyroid gland tumors", Korean J Otolaryngol-Head Neck Surg, 43(10), pp.1116~1121 (2000)