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Contrast-enhanced ultrasonography (CEUS) using early dynamic in microcirculation for localization of pathological parathyroid glands: First-line or complimentary diagnostic modality?
MedLine Citation:
PMID:  22214680     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Background: Contrast-enhanced ultrasonography (CEUS) represents a new diagnostic tool to localize pathological parathyroid glands. The aim of this study was to differentiate the capability of CEUS as first-line or complimentary modality for the detection of hyperfunctioning parathyroid glands. Methods: Sixty patients with pHPT were admitted to the University Hospital Regensburg between 8/2009 and 3/2011. Conventional and contrast-enhanced ultrasonography (CEUS) using a linear probe (6-9 MHz, LOGIQ E9/GE) was performed in all patients preoperatively. The sensitivity of CEUS was analyzed to determine its potential as first line or complimentary diagnostic procedure. Results: Using CEUS 98.3% of all pathological glands could be detected in the correct quadrant whereas conventional ultrasonography (70%) (p < 0.001) revealed less sensitivity. In all patients CEUS indicated a correct side localization of the hyperfunctioning parathyroid gland. The advantage of CEUS was the detection of the early dynamic on the capillary level immediately after contrast injection. Overall, CEUS permit minimally invasive video-assisted parathyroidectomy in 45 patients. 15 patients required conventional procedure due to concomitant goiter. All patients showed normal calcium and parathyroid hormone serum levels three months after surgery. Conclusions: CEUS represents a highly sensitive diagnostic modality for localization of pathologic parathyroid glands in patients with pHPT. Nevertheless, it can only be recommended as first-line diagnostic procedure in specialized clinical centers with experienced investigators.
Authors:
Matthias Hornung; Ernst Michael Jung; Christian Stroszczynski; Hans J Schlitt; Ayman Agha
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical hemorheology and microcirculation     Volume:  49     ISSN:  1875-8622     ISO Abbreviation:  Clin. Hemorheol. Microcirc.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2012-01-04     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9709206     Medline TA:  Clin Hemorheol Microcirc     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  83-90     Citation Subset:  IM    
Affiliation:
Department of Surgery, University Hospital Regensburg, Regensburg, Germany.
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