Weill Cornell Medical College/New York Presbyterian Hospital, New York, New York, USA.
Otolaryngol Head Neck Surg. 2012 Jan;146(1):33-9. doi: 10.1177/0194599811427243. Epub 2011 Nov 3.
To investigate whether parathyroid gland weight has an impact on the accuracy of preoperative localization of parathyroid adenomas with modified 4 dimensional computed tomography/ultrasound. And to determine if the weight of parathyroid adenomas can be calculated accurately based on the dimensions of the gland on the CT images.
Case series with chart review.
Tertiary care hospital.
One hundred forty-two patients who had a preoperative modified 4-dimensional computed tomography/ultrasound and underwent parathyroidectomy for hyperparathyroidism due to a parathyroid adenoma between 1998 and 2009. Charts were reviewed to identify (1) the sensitivity and specificity for localization of parathyroid adenomas according to gland weight and (2) correlation between preoperative estimate of parathyroid weight and the surgical weight of the parathyroid gland.
Modified 4-dimensional computed tomography/ultrasound displayed 92% sensitivity for localizing adenomas weighing <150 mg to the correct side of the neck (95% confidence interval [CI], 65%-99%), 100% sensitivity for glands weighing 150 to 500 mg (95%-100%), and 98% sensitivity for glands weighing >500 mg (92%-100%). For localization to the correct quadrant of the neck, sensitivity was 75% (95% CI, 47%-91%) for glands weighing <150 mg, 89% (79%-95%) for those weighing 150 to 500 mg, and 94% (85%-97%) for glands weighing >500 mg. A positive correlation was seen between the preoperative weight estimate based on imaging and the operative weight of the gland, with a Pearson correlation coefficient of 0.96.
Modified 4-dimensional computed tomography/ultrasound can closely predict the weight of parathyroid glands preoperatively and has good sensitivity for localization of adenomas, even in glands weighing less than 150 mg.
研究甲状旁腺重量是否会影响改良的四维 CT/超声对甲状旁腺腺瘤术前定位的准确性，并确定能否根据 CT 图像上腺体的尺寸准确计算甲状旁腺腺瘤的重量。
病例系列回顾。
三级护理医院。
1998 年至 2009 年间，有 142 名甲状旁腺腺瘤导致甲状旁腺功能亢进症的患者接受了术前改良的四维 CT/超声检查，并进行了甲状旁腺切除术。回顾图表以确定：（1）根据腺体重量定位甲状旁腺腺瘤的灵敏度和特异性；（2）术前甲状旁腺重量估计值与手术切除的甲状旁腺重量之间的相关性。
改良的四维 CT/超声对 <150mg 的腺瘤定位到颈部正确侧的灵敏度为 92%（95%置信区间 [CI]，65%-99%），150-500mg 的腺体灵敏度为 100%（95%-100%），>500mg 的腺体灵敏度为 98%（92%-100%）。对于定位到颈部正确象限，<150mg 的腺体灵敏度为 75%（95% CI，47%-91%），150-500mg 的腺体灵敏度为 89%（79%-95%），>500mg 的腺体灵敏度为 94%（85%-97%）。术前基于影像学的重量估计与手术切除的腺体重量之间存在正相关关系，Pearson 相关系数为 0.96。
改良的四维 CT/超声可以在术前准确预测甲状旁腺的重量，并且对腺瘤的定位具有良好的灵敏度，即使在重量小于 150mg 的腺体中也是如此。
