Prospective comparison of high resolution ultrasonography with technetium sestamibi scintigraphy and operative findings in detection of abnormally hyper functioning parathyroid gland/glands in primary hyperparathyroidism

Parvez Mohi Ud Din Dar; Munir Ahmad Wani; Khureed Alam Wani; Shariq Rashid Masoodi; Riaz Ahmad Misgar; Sajid Mohammad Wani; Afshan Anjum Wani; Liaqat Ahmad Malik

doi:10.18203/2349-2902.isj20164461

Authors

Parvez Mohi Ud Din Dar Department of General and Minimal Access Surgery, Metabolism, Sher-I-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Jammu & Kashmir, India
Munir Ahmad Wani Department of General and Minimal Access Surgery, Metabolism, Sher-I-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Jammu & Kashmir, India
Khureed Alam Wani Department of General and Minimal Access Surgery, Metabolism, Sher-I-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Jammu & Kashmir, India
Shariq Rashid Masoodi Department of Endocrinology and Metabolism, Sher-I-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Jammu & Kashmir, India
Riaz Ahmad Misgar Department of Endocrinology and Metabolism, Sher-I-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Jammu & Kashmir, India
Sajid Mohammad Wani Department of Psychiatry, SKIMS Medical College Hospital, Srinagar, Jammu & Kashmir, India
Afshan Anjum Wani Department of General and Minimal Access Surgery, Metabolism, Sher-I-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Jammu & Kashmir, India
Liaqat Ahmad Malik Department of General and Minimal Access Surgery, Metabolism, Sher-I-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Jammu & Kashmir, India

DOI:

https://doi.org/10.18203/2349-2902.isj20164461

Keywords:

Hypercalcemia hyperparathyroidism, 99mTc-sestamibi scintigraphy, Parathyroid adenoma, Ultrasonography

Abstract

Background:Ultrasonography is cheap, easily available and convenient modality of diagnosis.

Methods: We prospectively studied 61 patients with PHPT. Patients preoperatively underwent USG neck and MIBI scan, results were interpreted independently and compaired with intra operative findings.

Results:61 patients who underwent parathyroidectomy for PHPT were studied. Ultrasonography neck showed correct side in 46/51 (90%) and correct site in 32/51 (63%) patients with single parathyroid adenomas. MIBI scan showed correct side and site of parathyroid adenoma in 46/50 (92%) and 43/50 (86%) patients respectively. Patients with double adenomas USG neck showed positive results in all 5 patient with 100% sensitivity where as MIBI scan showed positive results in four out of five patients (80%). 1 patient with four gland hyperplasia USG picked three out of four enlarged glands while as MIBI scan not picked any of the enlarged glands. Operative findings revealed that right lower parathyroid gland was the most common gland involved (54%) followed by left lower (29%), right upper (6.6%), left upper (0%) and multiple / bilateral (9.6%).

Conclusions:USG is an affordable, conventional and useful tool in detecting enlarged parathyroid glands in most of the patients with PHPT, but operator dependant. However, when USG can’t detect enlarged parathyroid gland 99mTc-MIBI Scan is complimentary to it.

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