ECE2020 Audio ePoster Presentations Bone and Calcium (121 abstracts)
Colour doppler ultrasound: Preoperative location of parathyroid adenomas in primary hyperparathyroidism
Sara Amaral 1 , Teresa Rego 1 , Miguel Vasques 1 , Olga Gutu 1 , Ana Cláudia Martins 1 , Ana Palha 1 , Teresa Sabino 1 , Luísa Cortez 1 , António Afonso 1 , Fernando Fonseca 1 , Nuno Carrilho 2 , José Mário Coutinho 3 , Paula Tavares 3 & Ana Agapito 1
1Centro Hospitalar Universitário Lisboa Central, Endocrinology, Diabetes and Metabolism, Lisboa, Portugal; 2Centro Hospitalar Universitário Lisboa Central, Radiology, Lisboa, Portugal; 3Centro Hospitalar Universitário Lisboa Central, Endocrine Surgery, Lisboa, Portugal
Introduction: Parathyroid adenoma is the most frequent cause of primary hyperparathyroidism (PHPT). In recent years minimally invasive surgical techniques have challenged the traditional bilateral neck exploration. There are different imaging techniques for preoperative location of parathyroid adenomas. In this study the authors review the role of Doppler ultrasound focusing on its safety, availability and affordability.
Aim: To evaluate the role of Doppler ultrasound on preoperative location of parathyroid adenomas in patients with PHPT.
Methods: Retrospective study based on data from patients with PHPT that underwent parathyroidectomy between 2013 and 2019. Statistical analysis with Excel and IBM SPSS Statistics 20.
Results: Parathyroidectomy was performed in 135 patients (78,5% females) with PHPT between January 2013 and January 2019. The median age at diagnosis was 66 years old (22–89 years old). The median serum calcium and PTH were 11 mg/dl and 188 pg/ml respectively. The median follow up time was 2 years. Most patients performed 2 exams in order to detect the enlarged parathyroid(s). Cervical ultrasound without Doppler was the most performed exam (77%) and detected the lesion in 26% of the patients. The second most performed exam was sestamibi parathyroid scintigraphy (63.7%) and lesion was found in 62.8%. Doppler ultrasound was the third most requested exam (57.8%) and detected parathyroid adenoma in 88.5%. Parathyroid 4D computed tomography was performed in 37.8% of the patients and was diagnostic in 76.5%. In the group of patients that performed Doppler ultrasound (n = 78), the median adenoma size was 18 mm (5–34 mm). Preoperative location of the parathyroid adenomas based on Doppler ultrasound was compared to the surgical and histological findings. 90.9% were accurately located on the superior poles and 63% on the inferior. 82.4% were correctly located on the right side of the neck and 88.2% on the left. Diagnosis accuracy was not affected by the presence of thyroid nodules (P = 0.728). In 9 patients Doppler ultrasound did not find lesion and bilateral neck exploration was needed in 4 of them.
Conclusions: In this study Doppler ultrasound showed high diagnostic accuracy even in patients with nodular thyroid disease. Furthermore, its safety, affordability and availability should favor its use as a first line exam on preoperative location of parathyroid adenomas in PHPT.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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