Summary
99mTechnetium-201Thallium subtraction scanning was performed in 24 patients with primary (N=5) and secondary (N=19) hyperparathyroidism. The preoperative scintigraphy (N=12) detected 21 of 23 enlarged glands surgically removed and was helpful for detecting abnormal location especially in the mediastinum. Postoperative scanning in patients with recurrent hyperparathyroidism confirmed the excessive growth of the remaining half parathyroid after subtotal parathyroidectomy or a missing fifth parathyroid after total parathyroidectomy and autotransplantation. False negative results were due to tumor hyperplasia. The technique is recommended prior to repeated exploration in patients presenting persistent disease to predict the location of adenomas generally unsuccessfully detected by ultrasonography and computed tomography.
Résumé
La scintigraphie de soustraction des images Technetium-Thallium est réalisée sur 24 patients porteurs d'hyperparathyroïdie primaire dans 5 cas, et d'hyperparathyroïdie secondaire dans 19 cas. La scintigraphie préopératoire (N=12) montre 21 sur les 23 glandes hypertrophiées retrouvées et enlevées chirurgicalement. L'examen est d'une grande utilité dans les localisations anormales et surtout médiastinales. La scintigraphie post-opératoire chez les malades présentant une récidive d'hyperparathyroïdie confirme l'augmentation de volume du fragment parathyroïdien laissé en place après parathyroïdectomie subtotale ou la présence d'une 5e glande méconnue après parathyroïdectomie totale avec auto-transplantation. Les faux négatifs sont dûs aux simples hyperplasies. La technique est recommandée avant les interventions itératives pour hyperparathyroïdie persistante. Elle permet la localisation d'adénomes difficilement repérables à l'ultrasonographie ou au scanner.
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References
Brennan MF, Brown EM, Marx SJ, Spiegel AM, Broadus AE, Doppman JL, Webber B, Path FF, Aurbach GD (1978) Recurrent hyperparathyroidism from an autotransplanted parathyroid adenoma. N Engl J Med 299: 1057–1059
Doppman JL, Brennan MF, Koehler JO, Marx SJ (1977) Computed tomography for parathyroid localization. J Comput Assist Tomo 1: 30–36
Cohn KH, Silen W (1982) Lessons of parathyroid reoperations. Am J Surg 144: 511–517
Ferlin G, Borsato N, Perelli R (1981) Technetium-Thallium subtraction scan. A new method in the preoperative localization of parathyroid enlargement. Eur J Nucl Med 6: A 12
Meerden JA, James EM, Karsell PR, Charbonneau JW, Grant CS, Purnell DC (1982) Small part ultrasonography in primary hyperparathyroidism. Ann Surg 195: 774–780
Kovarik J, Willvonseder R, Höfer R, Küster W, Imhof H, Niederle B, Roka R, Dinstl K (1981) Mineral electrolyte Metab 5: 228–232
Moreau JF, Dubost C, Buy JN, Ferry J (1981) Dépistage ultrasonographique pré-opératoire des adénomes parathyroïdiens. Nouv Presse Med 10: 1923–1927
Roslyn JJ, Mulder DG, Gordon HE (1981) Persistent and recurrent hyperparathyroidism. Am J Surg 142: 21–25
Takagi H, Tominaga Y, Uchida K, Yamada N, Morimoto T, Yasme M (1983) Image diagnosis of parathyroid glands in chronic renal failure. Ann Surg 198: 74–79
Young AE, Gaunt JI, Croft DN, Collins RE, Wells CP, Coakley AJ (1983) Location of parathyroid adenomas by Thallium-201 and Technetium-99m subtraction scanning. Br Med J 286: 1384–1386
Wells SA, Grunnells JC, Gutman RA, Shelburne JD, Schneider AB, Sherwood LM (1977) The successful transplantation of frozen parathyroid tissue in man. Surgery 81: 86–90
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Godlewski, G., Artus, J.C., Granolleras, C. et al. The anatomical value of Technetium-Thallium subtraction scanning in detection and location of parathyroid adenomas. Anat. Clin 6, 281–285 (1984). https://doi.org/10.1007/BF01654460
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DOI: https://doi.org/10.1007/BF01654460