Doppman J L, Miller D L
National Institutes of Health, Department of Radiology, Bethesda, Maryland.
J Bone Miner Res. 1991 Oct;6 Suppl 2:S153-8; discussion S159. doi: 10.1002/jbmr.5650061431.
A number of recently published series were reviewed evaluating noninvasive localizing studies (ultrasound, thallium-technetium subtraction scintigraphy, computed tomography, and magnetic resonance imaging) in patients with primary hyperparathyroidism and no previous surgery. The average true positive (%) and false positive (%) rates were (1) ultrasound, 66 and 12; (2) Th/Tc scanning 55 and 13; (3) computed tomography, 63 and inadequately documented; (4) magnetic resonance imaging, 75 and 18. The success rate of initial operation in this group of patients is over 90%. There is no evidence that preoperative localizing studies shorten operating time or prevent surgical failures. For these reasons, noninvasive localization studies are not indicated in patients with primary hyperparathyroidism before initial surgery.
对近期发表的一系列评估原发性甲状旁腺功能亢进且未接受过手术患者的无创定位研究（超声、铊 - 锝减影闪烁扫描、计算机断层扫描和磁共振成像）的文献进行了综述。平均真阳性（%）和假阳性（%）率分别为：（1）超声，66%和12%；（2）铊/锝扫描，55%和13%；（3）计算机断层扫描，63%且记录不充分；（4）磁共振成像，75%和18%。该组患者初次手术的成功率超过90%。没有证据表明术前定位研究能缩短手术时间或防止手术失败。基于这些原因，对于原发性甲状旁腺功能亢进患者，初次手术前不建议进行无创定位研究。
