Skip to main content

Advertisement

SpringerLink
Log in

The Radiologist's role in acute endocrine problems

  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Ultrasound and computed tomography have had an enormous impact on the imaging procedures used in the detection of tumors of the parathyroids, pancreas, and adrenals. Ultrasound is now the examination of choice in localizing parathyroid adenomas in the neck prior to cervical exploration or after unsuccessful exploration. Its role as a screening test in patients without biochemical confirmation of hyperparathyroidism awaits further study. Computed tomography is useful in identifying mediastinal parathyroid adenomas in patients who have had unsuccessful neck explorations and islet-cell tumors of the pancreas if they are sufficiently large (greater than 2 cm). Angiography remains the most accurate method of localizing insulinomas prior to surgery. Computed tomography scanning has become the procedure of choice in localizing adrenal tumors and has sufficient sensitivity to be used as a screening test in patients without biochemical confirmation of an adrenal abnormality.

Résumé

L'échotomographie et la tomodensitométrie ont permis des progrès considérables dans la détection des tumeurs des parathyroïdes, du pancréas et des surrénales.

L'échotomographie représente actuellement la méthode de choix pour localiser les adénomes parathyroïdiens, soit avant l'intervention soit en cas d'échec de l'exploration chirurgicale. Son efficacité en tant que test de détection chez les malades dont l'hyperparathyroïdisme n'est pas confirmée par les explorations biologiques mérite d'être étudiée.

La tomodensitométrie permet d'identifier les adénomes parathyroïdiens médiastinaux lorsque l'exploration chirurgicale du cou est restée infructueuse. Elle permet de déceler les tumeurs insulaires des lors que leur diamètre est supérieur à deux centimètres, encore que l'angiographie pancréatique reste la meilleure méthode de diagnostic de ces lésions.

La tomodensitométrie est devenue la méthode de choix pour localiser les tumeurs des surrénales. Sa sensibilité est telle qu'elle peut être employée en tant qu'élément de détection des tumeurs surrénaliennes alors même que les explorations biologiques ne viennent pas confirmer leur existence.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Potchen, E.J., Watts, H.G., Awaad, H.K.: Parathyroid scintiscanning. Radiol. Clin. North Am.15:267, 1976

    Google Scholar 

  2. Sofianides, T., Chang, Y.S., Leary, J.S., Nichols, F.S.: Localization of parathyroid adenomas by cervical esophagrams. J. Clin. Endocrinol. Metab.46:587, 1978

    Google Scholar 

  3. Samuels, B.I., Dowdy, A.H., Lecky, J.W.: Parathyroid thermography. Radiology104:575, 1972

    Google Scholar 

  4. Doppman, J.L., Brennan, M.F., Koehler, J.O., Marx, S.J.: Computerized tomography for parathyroid localization. J. Comput. Assist. Tomogr.1:30, 1977

    Google Scholar 

  5. Sacks, B.A., Eisenberg, H., Pallotta, J.: Parathyroid adenomas: Cine-arteriography. AJR135:535, 1980

    Google Scholar 

  6. Doppman, J.L.: Parathyroid localization: Arteriography and venous sampling. Radiol. Clin. North Am.14:163, 1976

    Google Scholar 

  7. Sample, W.F., Mitchell, S.P., Bledsoe, R.C.: Parathyroid ultrasonography. Radiology127:485, 1978

    Google Scholar 

  8. Scheible, W., Deutsch, A.L., Leopold, G.R.: Parathyroid adenoma: Accuracy of preoperative localization by high-resolution real-time sonography. J. Clin. Ultrasound9:325, 1981

    Google Scholar 

  9. Simeone, J.F., Mueller, P.R., Ferrucci, J.T., Jr., van Sonnenberg, F., Wang, C.-A., Hall, D.A., Wittenberg, J.: High-resolution real-time sonography of the parathyroid. Radiology141:745, 1981

    Google Scholar 

  10. van Heerden, J.A., Beahrs, O.H., Woolner, L.B.: The pathology and surgical management of primary hyperparathyroidism. Surg. Clin. North Am.57:557, 1977

    Google Scholar 

  11. Bruining, H.A., van Houten, H., Juttmann, J.R., Lamberts, S.W.J., Birkenhäger, J.C.: The results of operative treatment of 615 patients with primary hyperparathyroidism. World J. Surg.5:85, 1981

    Google Scholar 

  12. Whitley, N.O., et al.: Computed tomography for localization of parathyroid adenomas. J. Comput. Assist. Tomogr.5:812, 1981

    Google Scholar 

  13. Kovarik, J., Willvonseder, R., Küster, W., Niederle, B., Rokā, R., Imhof, H.: Localization of parathyroid tumors by computed tomography. N. Engl. J. Med.303:885, 1980

    Google Scholar 

  14. Brown, L.R., Muhm, J.R., Sheedy, P.F.: Computed tomography of the chest. In Pulmonary Diagnosis Imaging and Other Techniques. C.E. Putnam, editor, New York, Appleton-Century-Crofts, 1981

    Google Scholar 

  15. Krudy, A.G., Doppman, J.L., Brennan, M.F., Marx, S.J., Spiegel, A.M., Stock, J.L., Aurbach, G.D.: The detection of mediastinal parathyroid glands by computed tomography, selective arteriography, and venous sampling. Radiology140:739, 1981

    Google Scholar 

  16. Edis, A.J., Sheedy, P.F., Beahrs, O.H., van Heerden, J.A.: Results of re-operation for hyperparathyroidism, with evaluation of preoperative localization studies. Surgery84:384, 1978

    Google Scholar 

  17. Doppman, J.L., Brown, E.M., Brennan, M.F., Spiegel, A., Marx, S.J., Aurbach, G.D.: Angiographic ablation of parathyroid adenomas. Radiology130:577, 1979

    Google Scholar 

  18. Fulton, R.E., Sheedy, P.F., McIlrath, D.C., Ferris, D.O.: Preoperative angiographic localization of insulin-producing tumors of the pancreas. Am. J. Roentgenol.123:367, 1975

    Google Scholar 

  19. Edis, A.J., McIlrath, D.C., van Heerden, J.A., et al.: Insulinoma—current diagnosis and surgical management. Curr. Prob. Surg.13:1, 1976

    Google Scholar 

  20. van Heerden, J.A., Edis, A.J., Service, F.J.: The surgical aspects of insulinomas. Ann. Surg.189:677, 1979

    Google Scholar 

  21. Stephens, D.H., Sheedy, P.F., James, E.M.: Pancreatic Neoplasms. Alimentary Tract Radiology, vol. 3, A.R. Margulis and H.J. Burhenne, editors,in press

  22. Dunnick, N.R., Long, J.A., Krudy, A., Shawker, T.H., Doppman, J.L.: Localizating insulinomas with combined radiographic methods. Am. J. Roentgenol.135:747, 1980

    Google Scholar 

  23. Dunnick, N.R., Doppman, J.L., Miller, S.R., Mc-Carthy, D.M.: Computed tomographic detection of nonbeta pancreatic islet cell tumors. Radiology135:117, 1980

    Google Scholar 

  24. Lunderquist, A., et al.: Selective pancreatic vein catheterization for hormone assay in endocrine tumors of the pancreas. Cardiovasc. Radiol.1:117, 1978

    Google Scholar 

  25. Hattery, R.R., Sheedy, P.F., Stephens, D.H., van Heerden, J.A.: Computed tomography of the adrenal gland. Semin. Roentgenol.16:290, 1981

    Google Scholar 

  26. Laursen, K.: CT for pheochromocytoma diagnosis. AJR134:277, 1980

    Google Scholar 

  27. Korobkin, M., White, E.A., Kressel, H.Y., Moss, A.A., Montagne, J.: Computed tomography in the diagnosis of adrenal disease. AJR132:231, 1979

    Google Scholar 

  28. White, E.A., Schambelan, M., Rost, C.R., Biglieri, E.G., Moss, A.A., Korobkin, M.: Use of computed tomography in diagnosing the cause of primary aldosteronism. N. Engl. J. Med.303:1503, 1981

    Google Scholar 

  29. Lecky, J.W., Wolfman, N.T., Modic, C.W.: Current concepts of adrenal angiography. Radiol. Clin. North Am.14:309, 1976

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Diagnostic Radiology, Mayo Clinic, 200 First Street SW, 55905, Rochester, Minnesota, USA

    Gerald R. May M.D., E. Meredith James M.D. & C. Michael Johnson M.D.

Authors
  1. Gerald R. May M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. E. Meredith James M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C. Michael Johnson M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

May, G.R., James, E.M. & Johnson, C.M. The Radiologist's role in acute endocrine problems. World J. Surg. 6, 725–734 (1982). https://doi.org/10.1007/BF01655365

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01655365

Keywords

Search

Navigation