Feldman E C, Wisner E R, Nelson R W, Feldman M S, Kennedy P C
Department of Medicine, School of Veterinary Medicine, University of California, Davis 95616, USA.
J Am Vet Med Assoc. 1997 Jul 1;211(1):54-6.
To compare a technique in which samples obtained from selected venous sites are analyzed for parathyroid hormone (PTH) concentration versus usefulness of cervical ultrasonography for localizing primary hyperparathyroidism (PHP) in dogs.
Prospective study.
12 dogs with PHP.
For each dog, blood samples were collected from the left and right jugular veins and 1 cephalic vein for determination of serum PTH concentration. Ultrasonography of the neck was performed in each dog. Each dog underwent exploratory surgery of the neck. Abnormal appearing parathyroid tissue was removed. Dogs were included in the study if serum calcium concentration decreased within 12 hours after surgery, hypercalcemia completely resolved within 96 hours after surgery, and serum calcium concentration was maintained within the reference range for at least 6 months after surgery.
Serum PTH concentrations from the 3 veins were similar in 11 of 12 dogs with PHP. In 1 dog, the serum PTH concentration from the jugular vein ipsilateral to a parathyroid adenoma was greater than that from the contralateral jugular or cephalic vein. Ultrasonography correctly identified a parathyroid mass and its location in 10 of 11 dogs with a solitary abnormal parathyroid gland and in 1 dog in which both parathyroid glands were enlarged.
Surgeons may benefit from knowing the location of abnormal parathyroid tissue in dogs with PHP before surgical exploration. Ultrasonography has potential value for identifying and localizing abnormal parathyroid tissue, whereas sample collection from selected sites for PTH analysis is not likely to be helpful.
比较对从选定静脉部位采集的样本进行甲状旁腺激素(PTH)浓度分析的技术与颈部超声检查对犬原发性甲状旁腺功能亢进(PHP)进行定位的效用。
前瞻性研究。
12只患有PHP的犬。
对每只犬,从左、右颈静脉和1条头静脉采集血样以测定血清PTH浓度。对每只犬进行颈部超声检查。每只犬均接受颈部探查手术。切除外观异常的甲状旁腺组织。如果术后12小时内血清钙浓度降低、术后96小时内高钙血症完全缓解且术后至少6个月血清钙浓度维持在参考范围内,则将犬纳入研究。
12只患有PHP的犬中,11只犬从3条静脉采集的血清PTH浓度相似。1只犬中,与甲状旁腺腺瘤同侧的颈静脉的血清PTH浓度高于对侧颈静脉或头静脉的血清PTH浓度。超声检查在11只患有单个异常甲状旁腺的犬中的10只以及在2个甲状旁腺均肿大的1只犬中正确识别出甲状旁腺肿块及其位置。
在进行手术探查前,外科医生若了解患有PHP的犬异常甲状旁腺组织的位置可能会受益。超声检查在识别和定位异常甲状旁腺组织方面具有潜在价值,而从选定部位采集样本进行PTH分析可能并无帮助。