Preoperative location of parathyroid adenomas in primary hyperparathyroidism: the role of cervical doppler ultrasound
Autor(a) principal: | |
---|---|
Data de Publicação: | 2022 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.21/15028 |
Resumo: | ABSTRACT - Introduction: Parathyroid adenoma is the most frequent cause of primary hyperparathyroidism. In recent years, the preoperative location of parathyroid adenomas allowed minimally invasive surgical techniques that have become preferred over traditional bilateral neck exploration. The more recent guidelines on this subject highlight the role of nuclear medicine imaging tests. The aim of this study was to review the current role of Doppler ultrasound (US) in assessing the preoperative location of parathyroid adenomas in patients with primary hyperparathyroidism. Material and methods: Retrospective study based on data from patients with primary hyperparathyroidism that underwent parathyroidectomy between January 2013 and January 2022 at the Centro Hospitalar Universitário Lisboa Central. Statistical analysis was performed with IBM SPSS Statistics, version 26.0.0.0®. Results: Parathyroidectomy was performed in 171 patients (77.8% females) with primary hyperparathyroidism. Cervical Doppler ultrasound was the most performed test (64.3%, n = 110) for preoperative location and detected a suspicious lesion in 98 patients (89.1%). The preoperative location of the parathyroid adenomas was assessed through the Doppler ultrasound and was compared with the surgical reports and histological findings; a correct identification was made in 76 patients (77.6%). Doppler ultrasound slightly underestimated the mean adenoma size (18.1 ± 7.7 mm preoperative versus 22 ± 8.4 mm postoperative). Calcium, parathyroid hormone levels, adenoma size, and the concomitant presence of thyroid nodules did not affect the accuracy of the Doppler ultrasound. Conclusion: Doppler ultrasound showed high diagnostic accuracy even in patients with nodular thyroid disease regardless of calcium and parathyroid hormone levels and adenoma size. Furthermore, its safety, affordability, and availability should favor its use as a first-line test in primary hyperparathyroidism to assess the preoperative location of parathyroid adenomas. |
id |
RCAP_e284dd6ef4c492d9a263164f2bcf8cb5 |
---|---|
oai_identifier_str |
oai:repositorio.ipl.pt:10400.21/15028 |
network_acronym_str |
RCAP |
network_name_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository_id_str |
7160 |
spelling |
Preoperative location of parathyroid adenomas in primary hyperparathyroidism: the role of cervical doppler ultrasoundLocalização pré-operatória de adenomas da paratiroide no hiperparatiroidismo primário: o papel da ecografia cervical com dopplerPrimary hyperparathyroidismParathyroid neoplasmsDiagnostic imagingUltrasonographyDopplerNeoplasias da paratiroideDiagnóstico por imagemHiperparatiroidismo primárioUltrassonografiaABSTRACT - Introduction: Parathyroid adenoma is the most frequent cause of primary hyperparathyroidism. In recent years, the preoperative location of parathyroid adenomas allowed minimally invasive surgical techniques that have become preferred over traditional bilateral neck exploration. The more recent guidelines on this subject highlight the role of nuclear medicine imaging tests. The aim of this study was to review the current role of Doppler ultrasound (US) in assessing the preoperative location of parathyroid adenomas in patients with primary hyperparathyroidism. Material and methods: Retrospective study based on data from patients with primary hyperparathyroidism that underwent parathyroidectomy between January 2013 and January 2022 at the Centro Hospitalar Universitário Lisboa Central. Statistical analysis was performed with IBM SPSS Statistics, version 26.0.0.0®. Results: Parathyroidectomy was performed in 171 patients (77.8% females) with primary hyperparathyroidism. Cervical Doppler ultrasound was the most performed test (64.3%, n = 110) for preoperative location and detected a suspicious lesion in 98 patients (89.1%). The preoperative location of the parathyroid adenomas was assessed through the Doppler ultrasound and was compared with the surgical reports and histological findings; a correct identification was made in 76 patients (77.6%). Doppler ultrasound slightly underestimated the mean adenoma size (18.1 ± 7.7 mm preoperative versus 22 ± 8.4 mm postoperative). Calcium, parathyroid hormone levels, adenoma size, and the concomitant presence of thyroid nodules did not affect the accuracy of the Doppler ultrasound. Conclusion: Doppler ultrasound showed high diagnostic accuracy even in patients with nodular thyroid disease regardless of calcium and parathyroid hormone levels and adenoma size. Furthermore, its safety, affordability, and availability should favor its use as a first-line test in primary hyperparathyroidism to assess the preoperative location of parathyroid adenomas.RESUMO - Introdução: O adenoma da paratiroide é a causa mais frequente de hiperparatiroidismo primário. Nos últimos anos, a localização pré-operatória de adenomas da paratiroide tem permitido técnicas cirúrgicas minimamente invasivas que se tornaram preferíveis à exploração cervical bilateral tradicional. As recomendações internacionais mais recentes relativamente a este tópico têm dado ênfase aos exames de imagem de medicina nuclear. Neste estudo, os autores revêem o papel atual da ecografia cervical com Doppler na localização pré-operatória de adenomas da paratiroide em doentes com hiperparatiroidismo primário. Material e Métodos: Estudo retrospetivo de doentes com hiperparatiroidismo primário submetidos a paratiroidectomia entre janeiro de 2013 e 2022 no Centro Hospitalar Universitário Lisboa Central. Análise estatística realizada com IBM SPSS Statistics, versão 26.0.0.0®.Resultados: Foram identificados 171 doentes com hiperparatiroidismo primário submetidos a paratiroidectomia (77,8% sexo femini-no). A ecografia cervical com Doppler foi o exame mais solicitado para localização pré-operatória de adenomas da paratiroide (64,3%, n = 110) e detetou a lesão em 98 doentes (89,1%). A análise comparativa da localização pré-operatória do adenoma da paratiroide baseada na ecografia cervical com Doppler com os achados cirúrgicos e histológicos demonstrou identificação correta do adenoma em 76 doentes (77,6%). A ecografia cervical com Doppler subestimou ligeiramente a dimensão dos adenomas (18,1 ± 7,7 mm pré--operatório versus 22 ± 8,4 mm pós-operatório). Os níveis de cálcio, paratormona, a dimensão do adenoma e a presença concomi-tante de nódulos tiroideus não afetou a eficácia diagnóstica da ecografia cervical com Doppler.Conclusão: A ecografia cervical com Doppler demonstrou elevada precisão diagnóstica independentemente da presença concomi-tante de nódulos tiroideus, dos níveis de cálcio e paratormona e da dimensão dos adenomas da paratiroide. A sua disponibilidade, segurança e custo aliado à capacidade diagnóstica demonstrada devem favorecer o seu uso como primeira linha na localização pré--operatória de adenomas da paratiroide no hiperparatiroidismo primário.Ordem dos MédicosRCIPLAmaral, SaraRego, TeresaPalha, AnaCarrilho, NunoCoutinho, José MárioTavares, PaulaSilva-Nunes, José2022-10-17T10:21:45Z2023-042023-04-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.21/15028engAmaral S, Rego T, Palha A, Carrilho N, Coutinho JM, Silva-Nunes J, et al. Preoperative location of parathyroid adenomas in primary hyperparathyroidism: the role of cervical doppler ultrasound. Acta Med Port. 2022;36(4):246-53.10.20344/amp.1873536240233info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-08-03T10:11:59Zoai:repositorio.ipl.pt:10400.21/15028Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T20:22:46.273730Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Preoperative location of parathyroid adenomas in primary hyperparathyroidism: the role of cervical doppler ultrasound Localização pré-operatória de adenomas da paratiroide no hiperparatiroidismo primário: o papel da ecografia cervical com doppler |
title |
Preoperative location of parathyroid adenomas in primary hyperparathyroidism: the role of cervical doppler ultrasound |
spellingShingle |
Preoperative location of parathyroid adenomas in primary hyperparathyroidism: the role of cervical doppler ultrasound Amaral, Sara Primary hyperparathyroidism Parathyroid neoplasms Diagnostic imaging Ultrasonography Doppler Neoplasias da paratiroide Diagnóstico por imagem Hiperparatiroidismo primário Ultrassonografia |
title_short |
Preoperative location of parathyroid adenomas in primary hyperparathyroidism: the role of cervical doppler ultrasound |
title_full |
Preoperative location of parathyroid adenomas in primary hyperparathyroidism: the role of cervical doppler ultrasound |
title_fullStr |
Preoperative location of parathyroid adenomas in primary hyperparathyroidism: the role of cervical doppler ultrasound |
title_full_unstemmed |
Preoperative location of parathyroid adenomas in primary hyperparathyroidism: the role of cervical doppler ultrasound |
title_sort |
Preoperative location of parathyroid adenomas in primary hyperparathyroidism: the role of cervical doppler ultrasound |
author |
Amaral, Sara |
author_facet |
Amaral, Sara Rego, Teresa Palha, Ana Carrilho, Nuno Coutinho, José Mário Tavares, Paula Silva-Nunes, José |
author_role |
author |
author2 |
Rego, Teresa Palha, Ana Carrilho, Nuno Coutinho, José Mário Tavares, Paula Silva-Nunes, José |
author2_role |
author author author author author author |
dc.contributor.none.fl_str_mv |
RCIPL |
dc.contributor.author.fl_str_mv |
Amaral, Sara Rego, Teresa Palha, Ana Carrilho, Nuno Coutinho, José Mário Tavares, Paula Silva-Nunes, José |
dc.subject.por.fl_str_mv |
Primary hyperparathyroidism Parathyroid neoplasms Diagnostic imaging Ultrasonography Doppler Neoplasias da paratiroide Diagnóstico por imagem Hiperparatiroidismo primário Ultrassonografia |
topic |
Primary hyperparathyroidism Parathyroid neoplasms Diagnostic imaging Ultrasonography Doppler Neoplasias da paratiroide Diagnóstico por imagem Hiperparatiroidismo primário Ultrassonografia |
description |
ABSTRACT - Introduction: Parathyroid adenoma is the most frequent cause of primary hyperparathyroidism. In recent years, the preoperative location of parathyroid adenomas allowed minimally invasive surgical techniques that have become preferred over traditional bilateral neck exploration. The more recent guidelines on this subject highlight the role of nuclear medicine imaging tests. The aim of this study was to review the current role of Doppler ultrasound (US) in assessing the preoperative location of parathyroid adenomas in patients with primary hyperparathyroidism. Material and methods: Retrospective study based on data from patients with primary hyperparathyroidism that underwent parathyroidectomy between January 2013 and January 2022 at the Centro Hospitalar Universitário Lisboa Central. Statistical analysis was performed with IBM SPSS Statistics, version 26.0.0.0®. Results: Parathyroidectomy was performed in 171 patients (77.8% females) with primary hyperparathyroidism. Cervical Doppler ultrasound was the most performed test (64.3%, n = 110) for preoperative location and detected a suspicious lesion in 98 patients (89.1%). The preoperative location of the parathyroid adenomas was assessed through the Doppler ultrasound and was compared with the surgical reports and histological findings; a correct identification was made in 76 patients (77.6%). Doppler ultrasound slightly underestimated the mean adenoma size (18.1 ± 7.7 mm preoperative versus 22 ± 8.4 mm postoperative). Calcium, parathyroid hormone levels, adenoma size, and the concomitant presence of thyroid nodules did not affect the accuracy of the Doppler ultrasound. Conclusion: Doppler ultrasound showed high diagnostic accuracy even in patients with nodular thyroid disease regardless of calcium and parathyroid hormone levels and adenoma size. Furthermore, its safety, affordability, and availability should favor its use as a first-line test in primary hyperparathyroidism to assess the preoperative location of parathyroid adenomas. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-10-17T10:21:45Z 2023-04 2023-04-01T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.21/15028 |
url |
http://hdl.handle.net/10400.21/15028 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Amaral S, Rego T, Palha A, Carrilho N, Coutinho JM, Silva-Nunes J, et al. Preoperative location of parathyroid adenomas in primary hyperparathyroidism: the role of cervical doppler ultrasound. Acta Med Port. 2022;36(4):246-53. 10.20344/amp.18735 36240233 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Ordem dos Médicos |
publisher.none.fl_str_mv |
Ordem dos Médicos |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
repository.mail.fl_str_mv |
|
_version_ |
1799133499601453056 |