Parathyroid ultrasonography: methodology, clinical evaluation

Autor: O.V. Kaminskyi
Jazyk: English<br />Ukrainian
Rok vydání: 2020
Předmět:
Zdroj: Mìžnarodnij Endokrinologìčnij Žurnal, Vol 16, Iss 5, Pp 396-407 (2020)
Druh dokumentu: article
ISSN: 2224-0721
2307-1427
DOI: 10.22141/2224-0721.16.5.2020.212743
Popis: Background. Parathyroid glands are the principal pathophysiological regulators of calcium-phosphorus metabolism, regulating and affecting kidneys, bones, both with cardiovascular, nervous, and other systems. Impaired parathyroid glands in combination with an imbalance in vitamin D system followed by the development of secondary hyperparathyroidism in the long term (more than 20–30 years) are the new aspects of the impact of ionizing radiation on the human body. The purpose was the investigation of the condition of parathyroid glands in people exposed to ionizing radiation as a result of the Chornobyl NPP (ChNPP) accident, elaboration of a methodology for clinical evaluation of parathyroid ultrasound data, taking into account clinical features. Materials and methods. The original prospective and retrospective study was a result of clinical observation of parathyroid glands state over 6 years in more than 6,000 patients irradiated as a result of the ChNPP accident. Results. 27–32 years after irradiation, we detected a high frequency of hyperplasia of the parathyroid glands in people irradiated as a result of the Chernobyl accident, primarily in those evacuated from the 30-kilometer exclusion zone and residents of radioactively contaminated areas. There is no direct relationship between structural changes in the parathyroid glands and their functional state. Normal unchanged parathyroid glands are not visualized on diagnostic ultrasound although being present in patients in the absence of load in the system of calcium-phosphorus metabolism and vitamin D hormone. Parathyroid glands in their structure and echogenicity completely coincide with the thyroid tissue. Conclusions. In any case of parathyroid glands detection, they should be assessed as parathyroid glands lesion and hyperplasia, regardless of size and/or volume, degree of echogenicity, or homogeneity/heterogeneity. Subsequent testing of hormonal and metabolic parameters (assay of serum parathyroid hormone, total calcium and ionized calcium, 25(OH)D), and clinical evaluation of the data obtained are mandatory.
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