지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 저널정보
- 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.89 No.6
- 발행연도
- 2015.11
- 수록면
- 300 - 305 (6page)
이용수
초록· 키워드
오류제보하기
Purpose: The role of preoperative localization studies is controversial in surgery of secondary hyperparathyroidism (sHPT). The aim of study was to evaluate the accuracy of preoperative ultrasonography (USG), CT, and 99mTc sestamibi scintigraphy (MIBI) in localizing enlarged parathyroid glands and to find the impact of correct localization in successful parathyroidectomy.
Methods: We compared operative findings with the preoperative localization of ultrasonography, computerized tomography and sestamibi scintigraphy in 109 patients with sHPT and identified well-visualized locations of abnormal parathyroid glands by evaluating the sensitivity of each imaging study with regard to typical locations of glands. We investigated the effect of preoperative imaging localization on the surgical outcomes by measuring the intraoperative parathyroid hormone (ioPTH) decrement for positive or negative imaging localization.
Results: USG (91.5%) had the highest sensitivity and MIBI (56.1%) had the lowest among 3 modalities. The sensitivity of combined USG and CT (95.0%) was the highest among combined 2 modalities. The combination of all 3 modalities (95.4%) had the highest sensitivity among the combinations of modalities. The reduction of ioPTH in patients with positive imaging localization (86.6%) was greater than negative imaging localization (84.2%), with no significant difference (P = 0.586). The recurrence or persistence of sHPT was not correlated with preoperative imaging localization (19 patients in negative, 16 in positive; P = 0.14).
Conclusion: Preoperative imaging localization contributed to surgical success but not to surgical outcomes. The combination of ioPTH measurement with imaging localization might be valuable for better surgical results in sHPT.
Methods: We compared operative findings with the preoperative localization of ultrasonography, computerized tomography and sestamibi scintigraphy in 109 patients with sHPT and identified well-visualized locations of abnormal parathyroid glands by evaluating the sensitivity of each imaging study with regard to typical locations of glands. We investigated the effect of preoperative imaging localization on the surgical outcomes by measuring the intraoperative parathyroid hormone (ioPTH) decrement for positive or negative imaging localization.
Results: USG (91.5%) had the highest sensitivity and MIBI (56.1%) had the lowest among 3 modalities. The sensitivity of combined USG and CT (95.0%) was the highest among combined 2 modalities. The combination of all 3 modalities (95.4%) had the highest sensitivity among the combinations of modalities. The reduction of ioPTH in patients with positive imaging localization (86.6%) was greater than negative imaging localization (84.2%), with no significant difference (P = 0.586). The recurrence or persistence of sHPT was not correlated with preoperative imaging localization (19 patients in negative, 16 in positive; P = 0.14).
Conclusion: Preoperative imaging localization contributed to surgical success but not to surgical outcomes. The combination of ioPTH measurement with imaging localization might be valuable for better surgical results in sHPT.
목차
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES
참고문헌 (28)
참고문헌 신청
[학술지(정기간행물)] - Tominaga Y. / 1997 / Histopathology, pathophysiology, and indications for surgical treatment of renal hyperparathyroidism / Semin Surg Oncol 13 : 78 ~ 86
[학술지(정기간행물)] - Martin KJ. / 2004 / Diagnosis, assessment, and treatment of bone turnover abnormalities in renal osteodystrophy / Am J Kidney Dis 43 : 558 ~ 565
[학술지(정기간행물)] - Akerstrom G. / 1984 / Surgical anatomy of human parathyroid glands / Surgery 95 : 14 ~ 21
[학술지(정기간행물)] - Roy M. / 2013 / Incidence and localization of ectopic parathyroid adenomas in previously unexplored patients / World J Surg 37 : 102 ~ 106
[학술지(정기간행물)] - Loftus KA. / 2007 / Value of sestamibi scans in tertiary hyperparathyroidism / Laryngoscope 117 : 2135 ~ 2138
[학술지(정기간행물)] - Martin KJ. / 2004 / Diagnosis, assessment, and treatment of bone turnover abnormalities in renal osteodystrophy / Am J Kidney Dis 43 : 558 ~ 565
[학술지(정기간행물)] - Akerstrom G. / 1984 / Surgical anatomy of human parathyroid glands / Surgery 95 : 14 ~ 21
[학술지(정기간행물)] - Roy M. / 2013 / Incidence and localization of ectopic parathyroid adenomas in previously unexplored patients / World J Surg 37 : 102 ~ 106
[학술지(정기간행물)] - Loftus KA. / 2007 / Value of sestamibi scans in tertiary hyperparathyroidism / Laryngoscope 117 : 2135 ~ 2138
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UCI(KEPA) : I410-ECN-0101-2016-514-002155093