Bildgebende Diagnostik in der Nebenschilddrüsenchirurgie
| Autor: | Wojciech Makarewicz, Andrzej J. Lachinski, Tomasz Osęka, Z. Gruca, Lukasz Kaska, Tomasz Stefaniak, Jarosław Kobiela, Piotr Lass |
|---|---|
| Rok vydání: | 2004 |
| Předmět: | |
| Zdroj: | Zentralblatt für Chirurgie. 129:87-91 |
| ISSN: | 1438-9592 0044-409X |
| DOI: | 10.1055/s-2004-816282 |
| Popis: | BACKGROUND Despite the progress in the imaging techniques, the satisfactory preoperative detection of the hyperactive parathyroid glands has not been guaranteed yet. Many complementary techniques have been introduced including ultrasound imaging, CT-scanning, MRI and scintigraphy, also supported by intraoperative methods (methylene blue injections, gamma-probing, intraoperative PTH level assessment) simplifying the detection of the glands and assuring the surgeon on the adequacy of his/her treatment. DESIGN The authors describe the methods instituted nowadays, and compare their quality parameters, applicability, indications and limitations. The critical review is accompanied by a brief presentation of own experience including 172 cases of hyperparathyroidism treated in the Department of General, Gastroenterological and Endocrinological Surgery, Medical University of Gdansk, Poland between 1996 and 2003. CONCLUSIONS The authors conclude that radionuclid-based methods (Tc (99m)-MIBI preoperative scintigraphy and Tc (99m)-MIBI intraoperative gamma-probing) seem to be the most effective in both preoperative and intraoperative detection of hyperfunctioning parathyroids. It is also suggested that the effectiveness of the imaging is higher in primary than in secondary hyperparathyroidism. It is underlined that the effectiveness of the operative treatment is strongly determined by the experience of the operating endocrine surgeon. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|