Siordia Cruz Nahomi S, Gallegos De Luna Carlos F, Ramírez-Preciado Isac I, Zavala Mejía Jacob J, Peña Montañez Gloria A, González Manuel Sánchez, Delgado Hernández Gonzalo, Pérez Navarro José V
General Surgery, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social (IMSS), Guadalajara, MEX.
Cureus. 2025 Apr 10;17(4):e82021. doi: 10.7759/cureus.82021. eCollection 2025 Apr.
Primary hyperparathyroidism (pHPT) is the most common endocrine disorder responsible for hypercalcemia in non-hospitalized patients. When indicated for parathyroidectomy for pHPT, preoperative imaging is recommended to localize the affected parathyroid glands, including neck ultrasonography and 99m-Tc-sestaMIBI scintigraphy. The aim of this study was to investigate and compare the findings obtained by ultrasonography and scintigraphy in the preoperative evaluation. A retrospective review was conducted on all patients who underwent partial parathyroidectomy for a diagnosis of pHPT between January 2022 and December 2024 in a specialized center in Mexico. The locations according to scintigraphy and ultrasound were compared using the McNemar test, and specificity, sensitivity, negative predictive value (NPV), and positive predictive value (PPV) were determined. A significant difference was observed only in the case of non-localization of affected glands (p<0.0001). For scintigraphy, sensitivity was 100%, specificity 60.70%, PPV 73.7%, and NPV 100%. For ultrasonography, sensitivity was 60%, specificity 87.5%, PPV 93.2%, and NPV 25.93%. The concordance observed between the preoperative localization findings obtained by 99m-Tc-sestaMIBI scintigraphy and ultrasonography in patients with pHPT highlights the enduring value of ultrasonography as a preoperative tool, due to its accessibility and cost-effectiveness.
原发性甲状旁腺功能亢进症（pHPT）是门诊患者高钙血症最常见的内分泌疾病。当因pHPT而有甲状旁腺切除指征时，建议进行术前成像以定位受影响的甲状旁腺，包括颈部超声检查和99m锝-甲氧基异丁基异腈（99m-Tc-sestaMIBI）闪烁扫描。本研究的目的是调查和比较超声检查和闪烁扫描在术前评估中的结果。对2022年1月至2024年12月在墨西哥一家专业中心因诊断为pHPT而接受甲状旁腺部分切除术的所有患者进行了回顾性研究。使用McNemar检验比较闪烁扫描和超声检查所确定的位置，并确定特异性、敏感性、阴性预测值（NPV）和阳性预测值（PPV）。仅在受影响腺体未定位的情况下观察到显著差异（p<0.0001）。对于闪烁扫描，敏感性为100%，特异性为60.70%，PPV为73.7%，NPV为100%。对于超声检查，敏感性为60%，特异性为87.5%，PPV为93.2%，NPV为25.93%。pHPT患者术前通过99m-Tc-sestaMIBI闪烁扫描和超声检查获得的定位结果之间的一致性突出了超声检查作为一种术前工具的持久价值，这得益于其可及性和成本效益。
