Roza A M, Wexler M J, Stein L, Goltzman D
Can J Surg. 1984 Jul;27(4):334-6.
Eighteen patients with hyperparathyroidism underwent high-resolution computerized tomography of the neck and superior mediastinum to assess the accuracy of the method in localizing diseased parathyroid glands preoperatively. The tomograms were correlated with surgical and pathological findings. Four scans were technically unsatisfactory. Of the remaining 14 scans, 8 showed an enlarged parathyroid gland; in 7 cases, the scan correctly identified the location of the diseased gland while in 1 case, the side of the lesion was incorrect. The other six scans did not show an abnormal parathyroid. These glands varied in size from 0.05 to 5.0 cm3 at the time of pathological examination. Three patients were undergoing re-exploration for persistent disease; technically acceptable scans were obtained in two and, in both, the location of the adenoma was correctly identified. Excluding patients with technically unsatisfactory scans, this technique has a sensitivity of 50% (7/14) and a false-negative rate of 43% (6/14) independent of gland size. However, in the eight scans interpreted as positive, the correct side of the lesion was localized in 7 (88%). This technique is not recommended for routine preoperative localization but may be of value in re-exploration for persistent disease.
18例甲状旁腺功能亢进患者接受了颈部和上纵隔的高分辨率计算机断层扫描，以评估该方法术前定位病变甲状旁腺的准确性。将断层扫描结果与手术及病理结果进行对比。4次扫描在技术上不达标。在其余14次扫描中，8次显示甲状旁腺增大；其中7例扫描正确识别了病变腺体的位置，1例病变侧别有误。另外6次扫描未显示甲状旁腺异常。病理检查时这些腺体大小在0.05至5.0立方厘米之间。3例患者因疾病持续存在而接受再次探查；2例获得了技术上可接受的扫描结果，且两者均正确识别了腺瘤的位置。排除技术上不达标扫描的患者，该技术的敏感性为50%（7/14），假阴性率为43%（6/14），与腺体大小无关。然而，在解读为阳性的8次扫描中，7次（88%）正确定位了病变侧别。该技术不推荐用于常规术前定位，但对因疾病持续存在而进行的再次探查可能有价值。
