Tierklinik Hofheim.
Department of Veterinary Clinical Sciences, Clinic for Small Animals, Justus-Liebig-University Giessen.
Tierarztl Prax Ausg K Kleintiere Heimtiere. 2020 Oct;48(5):313-320. doi: 10.1055/a-1236-4542. Epub 2020 Oct 21.
Aim of our prospective pilot study was to assess the feasibility of computed tomography (CT) to visualize the normal parathyroid gland in dogs and provide a description of its CT appearance.
A total of 25 dogs, which received CT imaging including the neck region for diseases unrelated to the thyroid or parathyroid glands, were enrolled. Inclusion criteria were a normal physical examination, an unremarkable complete blood count and serum chemistry profile. Pre and post contrast CT images were acquired using a 16-slice helical scanner with an 18 cm field of view, 1 mm slice thickness and a 512 × 512 matrix. Post contrast images were obtained 30-45 seconds following contrast medium injection (early venous phase). CT-images were independently reviewed by 2 radiologists. Visibility of the parathyroid gland was recorded and inter-observer agreement was calculated. For all visualized parathyroid glands the following parameters were assessed: size, density in Hounsfield units (HU) on pre and post contrast images, density of the thyroid gland and border definition (excellent, moderate, poor).
Only 20 respectively 25 parathyroid glands could be visualized by the 2 observers. The number did not vary between pre and post contrast images. The inter-observer agreement for the identification was fair (κ = 0.40). Length, width and height (mean ± standard deviation) of the parathyroid gland were 4.2 × 2.5 × 2.9 mm ± 1.3 × 0.8 × 1.0 mm. The density was 39.7 ± 20.6 HU on pre contrast images and 103.1 ± 47.1 HU on post contrast images, thus the organ was hypoattenuating compared to the thyroid gland on pre (166.7 ± 34.3 HU) and post contrast (234.0 ± 60.1 HU) images.
This study offers the first description of the CT appearance of the presumed normal canine parathyroid gland. However, the overall visibility was poor.
Despite the overall poor visibility of the parathyroid gland it was occasionally visible and its CT dimensions were larger as described for ultrasound in this group of dogs, which showed no clinical signs of hyperparathyroidism. Thus, visibility of the parathyroid gland on CT may not necessarily imply parathyroid disease. However, further research is necessary.
我们前瞻性试点研究的目的是评估计算机断层扫描(CT)在犬中可视化正常甲状旁腺的可行性,并提供其 CT 表现的描述。
共纳入 25 只因甲状腺或甲状旁腺疾病以外的疾病接受颈部 CT 成像的犬。纳入标准为体格检查正常,全血细胞计数和血清化学谱无异常。使用 16 层螺旋 CT 扫描仪进行 CT 平扫和增强扫描,视野为 18cm,层厚为 1mm,矩阵为 512×512。对比剂注射后 30-45 秒(早期静脉相)获得增强 CT 图像。2 位放射科医生独立对 CT 图像进行了回顾。记录甲状旁腺的显示情况,并计算了观察者间的一致性。对所有可见甲状旁腺,评估了以下参数:大小、平扫和增强后 CT 值(HU)、甲状腺密度和边界清晰度(极好、中度、差)。
仅 2 位观察者分别可显示 20 个和 25 个甲状旁腺。增强前后图像的甲状旁腺数量无差异。甲状旁腺识别的观察者间一致性为中等(κ=0.40)。甲状旁腺的长、宽、高(均值±标准差)分别为 4.2×2.5×2.9mm±1.3×0.8×1.0mm。平扫 CT 值为 39.7±20.6HU,增强后 CT 值为 103.1±47.1HU,因此与平扫(166.7±34.3HU)和增强后(234.0±60.1HU)甲状腺相比,该器官呈低衰减。
本研究首次描述了疑似正常犬甲状旁腺的 CT 表现。然而,整体可见度较差。
尽管甲状旁腺的整体可见度较差,但在该组无甲状旁腺功能亢进临床症状的犬中,甲状旁腺偶尔可见,其 CT 大小与超声描述的相似。因此,CT 上甲状旁腺的可见性不一定意味着甲状旁腺疾病。然而,还需要进一步研究。