Department of Surgery, 12320University of Puerto Rico, San Juan, Puerto Rico.
Am Surg. 2022 Jul;88(7):1549-1550. doi: 10.1177/00031348221083938. Epub 2022 Mar 25.
Parathyroidectomy is the only cure for primary hyperparathyroidism and is effective in more than 95% of cases at initial surgical intervention. However, 2.5-5% of cases have recurrent or persistent disease. Pre-operative imaging is recommended in patients undergoing redo parathyroidectomy to localize the diseased gland. Parathyroid 4D CT scan is now widely used for localization and has been reported to have improved accuracy when compared to other imaging modalities. We conducted a retrospective study of all redo parathyroidectomies from 2017 to 2021 at a single tertiary parathyroid referral center. We evaluated pre-operative 4D CT scan results and compared them to intra-operative findings to determine if 4D CT scan correctly predicted the location of the diseased gland. 4D CT scan had a concordance of 87% with intra-operative findings. 4D CT scan is highly effective identifying parathyroid pathology in re-operative cases and can be used as a pre-operative tool to guide surgical management.
甲状旁腺切除术是原发性甲状旁腺功能亢进症的唯一治愈方法，在初次手术干预时，超过 95%的病例有效。然而，有 2.5-5%的病例存在疾病复发或持续存在。在进行再次甲状旁腺切除术的患者中，推荐进行术前影像学检查以定位病变的腺体。甲状旁腺 4D CT 扫描目前广泛用于定位，与其他影像学方式相比，报道称其准确性有所提高。我们对 2017 年至 2021 年期间在一家三级甲状旁腺转诊中心进行的所有再次甲状旁腺切除术进行了回顾性研究。我们评估了术前 4D CT 扫描结果，并将其与术中发现进行比较，以确定 4D CT 扫描是否正确预测了病变腺体的位置。4D CT 扫描与术中发现的符合率为 87%。4D CT 扫描在复发性病例中识别甲状旁腺病变非常有效，可作为术前工具指导手术管理。
