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Selective Venous Sampling for Hyperparathyroidism

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Diagnosis and Management of Endocrine Disorders in Interventional Radiology

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Abstract

Selective venous sampling (SVS) is a minimally invasive interventional technique for localizing the area with elevated intact parathyroid hormone (iPTH) in the large central and small neck veins. SVS comprises super-selective venous sampling (sSVS) for small veins, such as thyroid veins, and conventional SVS for large central neck veins, such as internal jugular veins (IJV) and brachiocephalic vein (BCV), to detect a step-up of iPTH level. At present, SVS is indicated for recurrent or persistent hyperparathyroidism localization in postoperative patients as well as with negative and discordant results on noninvasive imaging studies. Knowledge of the anatomy of superior, middle, and inferior thyroid veins is crucial to conduct SVS. Multi-detector CT is helpful to assess the thyroid veins before the procedure; however, retrograde venography is necessary to depict the thyroid venous plexus. A gradient of twofold to the baseline is an accepted threshold indicating a positive test result. Because of the higher sensitivity, sSVS should be performed when possible.

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Authors and Affiliations

  1. Department of Radiology, St. Marianna University School of Medicine, Yokohama City Seibu Hospital, Yokohama, Kanagawa, Japan

    Takayuki Yamada & Akiyuki Kotoku

Authors
  1. Takayuki Yamada
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  2. Akiyuki Kotoku
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Correspondence to Takayuki Yamada .

Editor information

Editors and Affiliations

  1. Division of Vascular and Interventional RadiologyDepartment of Radiology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA

    Hyeon Yu

  2. Division of Vascular and Interventional RadiologyDepartment of Radiology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA

    Charles T. Burke

  3. Division of Vascular and Interventional RadiologyDepartment of Radiology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA

    Clayton W. Commander

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Yamada, T., Kotoku, A. (2022). Selective Venous Sampling for Hyperparathyroidism. In: Yu, H., Burke, C.T., Commander, C.W. (eds) Diagnosis and Management of Endocrine Disorders in Interventional Radiology. Springer, Cham. https://doi.org/10.1007/978-3-030-87189-5_7

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  • DOI: https://doi.org/10.1007/978-3-030-87189-5_7

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