| The Utility of Multidetector Computed Tomography for Detection of Parathyroid Disease in the Setting of Primary Hyperparathyroidism. | |
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MedLine Citation:
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PMID: 21955750 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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PURPOSE: The aim of this study was to evaluate the accuracy of multidetector computed tomography (MDCT) in the detection of parathyroid adenoma and hyperplasia in the setting of primary hyperparathyroidism. METHODS: Records of 48 patients with biochemically confirmed primary hyperparathyroidism, who underwent preoperative imaging with 16- or 64-slice contrast-enhanced MDCT and subsequent successful parathyroidectomy over a 3-year period, were reviewed. Two radiologists, blinded to the operative and histologic findings, independently evaluated multiplanar computed tomographic images for all patients. RESULTS: On pathologic examination, 63 abnormal glands were confirmed in 41 female and 7 male patients (mean age, 63 years). Of the 63 abnormal glands, 40 were adenomatous and 23 were hyperplastic. MDCT demonstrated an 88% (95% confidence interval [CI], 77%-99%) positive predictive value for localizing abnormal hyperfunctioning parathyroid glands. The sensitivity of MDCT in detecting single-gland disease was 80% (95% CI, 68%-92%); whereas, the specificity for ruling out hyperfunctioning parathyroid tissue, either adenomatous or hyperplastic, was 75% (95% CI, 51%-99%). The sensitivity for exclusively localizing parathyroid hyperplasia was 17% (95% CI, 2%-33%). The parathyroid adenomas were substantially larger and heavier than their hyperplastic counterparts, with an average weight of 1.51 g (range, 0.08-6.00 g) and 0.42 g (range, 0.02-2.0 g) for adenoma and hyperplasia, respectively. CONCLUSIONS: Contrast-enhanced MDCT demonstrated an 88% positive predictive value for localizing adenomatous and hyperplastic parathyroid glands. The poor sensitivity for detection of multigland disease was likely a result of the smaller size and weight of the abnormal hyperplastic glands. |
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Authors:
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Dorota D Linda; Bernard Ng; Ryan Rebello; Srinivasan Harish; George Ioannidis; J E M Young |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-9-26 |
Journal Detail:
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Title: Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes Volume: - ISSN: 0846-5371 ISO Abbreviation: - Publication Date: 2011 Sep |
Date Detail:
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Created Date: 2011-9-29 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8812910 Medline TA: Can Assoc Radiol J Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Radiology, McMaster University, Hamilton, Ontario, Canada. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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