Imaging for primary hyperparathyroidism--an evidence-based analysis.

摘要: Imaging in patients with primary hyperparathyroidism has been proven difficult. During the last decade, sestamibi scintigraphy and ultrasound (US) have used various success. The importance of these procedures risen since minimal invasive parathyroid (MIP) surgery also developed, it is claimed that preoperative localization usually needed before embarking on such a procedure. We scanned most recent literature this matter order to identify evidence, using commonly accepted grading, concluded number recommendations. found evidence at level III leading recommendations grade B, recommended first test, but US by an experienced investigator may be alternative. MIP performed when both tests are concordant, case only one test being positive, unilateral exploration use intraoperative PTH measurements recommended. Bilateral neck negative. For reoperative procedures, repeat investigations recommended, US-guided fine needle aspiration as well venous sampling. However, for weaker—level IV, still B.