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- Title
Surgeon-performed Ultrasound for Primary Hyperparathyroidism.
- Authors
SCHENK III, WORTHINGTON G.; HANKS, JOHN B.; SMITH, PHILIP W.
- Abstract
The role of preoperative parathyroid imaging continues to evolve. This study evaluated whether surgeon-performed ultrasound (U/S) obviates the need for other imaging studies and leads to a focused exploration with a high degree of surgical success. From July 2010 to February 2012, 200 patients presenting with nonfamilial primary hyperparathyroidism underwent neck U/S in the surgeon's office. The U/S interpretation was classified as Class 1 if an adenoma was identified with high confidence, Class 2 if a possible but not definite enlarged gland was imaged, and Class 0 (zero) if no adenoma was identified. The findings were correlated with subsequent intraoperative findings. There were 144 Class 1 U/Ss (72%); of 132 patients coming to surgery, 96.2 per cent had surgical findings concordant with preoperative U/S and all had apparent surgical cure. Twenty-nine patients (14.5%) had Class 2 U/S; the 31 per cent confirmed false-positives in this group were usually colloid nodules. Fourteen of 27 with Class 0 U/S underwent surgery after being offered dynamically enhanced computed tomography scan. All 200 patients were apparent surgical cures. Surgeon-performed U/S is expedient, convenient, inexpensive, and accurate. A clearly identified adenoma can safely lead to a focused limited exploration and avoid additional imaging 93 per cent of the time.
- Subjects
PARATHYROID gland diseases; ULTRASONIC imaging; HYPERPARATHYROIDISM; SURGEONS; SURGERY
- Publication
American Surgeon, 2013, Vol 79, Issue 7, p681
- ISSN
0003-1348
- Publication type
Article
- DOI
10.1177/000313481307900711