Erbil Yeşim, Barbaros Umut, Tükenmez Mustafa, Işsever Halim, Salmaslioğlu Artür, Adalet Işik, Ozarmağan Selçuk, Tezelman Serdar
Department of General Surgery, Istanbul Medical Faculty, Istanbul University, 34093, Capa, Istanbul, Turkey.
World J Surg. 2008 Apr;32(4):566-71. doi: 10.1007/s00268-007-9389-4.
Although the sensitivity of preoperative localization techniques is high for solitary parathyroid adenomas, negative imaging study results are inevitable. The weight and location of the parathyroid adenoma may contribute to the negative results. We aimed to study the impact of adenoma weight and ectopic location of the parathyroid adenoma on ultrasonography and sestamibi scan results. The patients were divided into two groups according to adenoma location. Group 1 consisted of 36 patients with ectopic location, and group 2 consisted of 149 patients with normal location. Parathyroid adenoma weight and the results of imaging studies were determined in all patients. Of 185 patients operated on for hyperparathyroidism, 36 (19.4%) had ectopic parathyroid glands. There was a positive correlation between adenoma weight and positive imaging studies, whereas ectopic location did not correlate with negative imaging study results. There was no significant difference between the ectopic adenoma ratio of patients with negative and positive imaging study results. The weight of the ectopic parathyroid adenoma was significantly lower in patients with negative imaging study results than in patients with positive imaging study results (p = 0.001). According to the analysis of variance, patients with higher-weight adenomas have positive imaging study results irrespective of ectopic location. For both normal and ectopic adenoma locations, adenoma weight was found only to be a factor that positively influences imaging study results.
尽管术前定位技术对孤立性甲状旁腺腺瘤的敏感性较高,但影像学检查结果为阴性仍不可避免。甲状旁腺腺瘤的重量和位置可能导致阴性结果。我们旨在研究甲状旁腺腺瘤的重量和异位位置对超声检查和锝[99mTc]甲氧基异丁基异腈扫描结果的影响。根据腺瘤位置将患者分为两组。第1组由36例异位患者组成,第2组由149例正常位置患者组成。测定所有患者的甲状旁腺腺瘤重量和影像学检查结果。在185例因甲状旁腺功能亢进接受手术的患者中,36例(19.4%)有异位甲状旁腺。腺瘤重量与影像学检查阳性结果之间存在正相关,而异位位置与影像学检查阴性结果无关。影像学检查结果为阴性和阳性的患者的异位腺瘤比例之间无显著差异。影像学检查结果为阴性的患者的异位甲状旁腺腺瘤重量显著低于影像学检查结果为阳性的患者(p = 0.001)。根据方差分析,无论异位位置如何,腺瘤重量较高的患者影像学检查结果为阳性。对于正常和异位腺瘤位置,均发现腺瘤重量是唯一对影像学检查结果有积极影响的因素。