The Diagnostic Accuracy of High Resolution Ultrasound Imaging for Detection of Secondary Hyperparathyroidism in Patients with Chronic Renal Failure
Abstract
Ultrasound is one of the preferred modalities for evaluation of the parathyroid glands. This study was undertaken to determine the accuracy of high resolution ultrasound for secondary hyperparathyroidism in patients with chronic renal failure. From March 2008 to March 2009, ninety-one hemodialysis patients were examined by high resolution ultrasound (14 MHz) of the parathyroid glands in comparison to parathyroid hormone level. 43.9% of patients showed enlarged parathyroid glands with an average of 8.7 mm. The mean parathyroid hormone level of patients with enlarged parathyroid glands on sonography was 503 ± 450 pg/ml. We observed a significant correlation between parathyroid hormone level and enlarged parathyroid glands (P<0.0001). Sensitivity and specificity of sonography for detection of secondary hyperparathyroidism were 62.5% and 85.7% respectively. In conclusion, our study showed that high resolution sonography is a useful noninvasive method for the evaluation of secondary hyperparathyroidism in patients on hemodialysis and that sonographically enlarged glands may be a measure of severity of secondary hyperparathyroidism.
Malluche H, Faugere MC. Renal bone disease 1990: an unmet challenge for the nephrologist. Kidney Int 1990;
Hopkins CR, Reading CC. Thyroid and parathyroid imaging. Semin Ultrasound CT MR 1995; 16(4):279-95.
Renato Roithmann, Shia Salem, Joel C Kirsh, Edward E Kassel, Irving B Rosen, Arnold M Noyek. Parathyroid imaging. Operative Techniques in Otolaryngology-Head and Neck Surgery 1994;5(2):84-90.
Fukagawa M, Kurokawa K. Pathogenesis and medical treatment of secondary hyperparathyroidism. Semin Surg Oncol 1997; 13(2):73-7.
Takebayashi S, Matsui K, Onohara Y, Hidai H. Sonography for early diagnosis of enlarged parathyroid glands in patients with secondary hyperparathyroidism. AJR Am J Roentgenol 1987; 148(5):911-4.
Muros MA, Bravo Soto J, López Ruiz JM, Rodríguez- Portillo M, Ramírez Navarro A, Bellón Guardia M, Perán F, Llamas-Elvira JM. Two-phase scintigraphy with technetium 99m-sestamibi in patients with hyperparathyroidism due to chronic renal failure. Am J Surg 2007; 193(4):438-42.
Robert Udelsman. Secondary hyperparathyroidism. Operative Techniques in General Surgery 1999;1(1):62-70.
Obregón LM, Taylor MF, Mir G, Pereyra CA, Pianzola H, Petrone H, Baran M, Menna ME. Parathyroidectomy for parathyroid carcinoma in renal transplantation. Transplant Proc 2005; 37(2):973-6.
Jevtic V. Imaging of renal osteodystrophy. Eur J Radiol 2003; 46(2):85-95.
DiTella PJ, Lang GR. Parathyroid dysfunction end stage renal disease. Otolaryngol Clin North Am 1980; 13(1):193-201.
Peacock M. Primary hyperparathyroidism and the kidney: biochemical and clinical spectrum. J Bone Miner Res. 2002; 17 Suppl 2:N87-94.
Canellos HM, Cooper J, Paek A, Chien J. Multiple calcified deposits along the eyelid margins secondary to chronic renal failure and hyperparathyroidism. Optometry 2005; 76(3):181-4.
Thierry Defechereux, Michel Meurisse. Renal hyperparathyroidism: Current therapeutic approaches and future directions. Operative Techniques in Otolaryngology-Head and Neck Surgery 2009;20(1):71-8.
Sancho J, Sitges-Serra A: Metabolic complications of secondary hyperparathyroidism, in Clark O, Duh Q, Kebebew E (eds): Textbook of Endocrine surgery. Ohiladelphia, Elsevier. Saunders, 2005, pp502-509
Ozcan UA, Oktay I. Assessment of parathyroid glands in hemodialysis patients by using color Doppler sonography. Eur Radiol 2009; 19(11):2750-5.
Seehofer D, Steinmüller T, Rayes N, Podrabsky P, Riethmüller J, Klupp J, Ulrich F, Schindler R, Frei U, Neuhaus P. Parathyroid hormone venous sampling before reoperative surgery in renal hyperparathyroidism: comparison with noninvasive localization procedures and review of the literature. Arch Surg 2004;139(12):1331-8.
Reidel MA, Schilling T, Graf S, Hinz U, Nawroth P, Büchler MW, Weber T. Localization of hyperfunctioning parathyroid glands by selective venous sampling in reoperation for primary or secondary hyperparathyroidism. Surgery 2006; 140(6):907-13.
Sukan A, Reyhan M, Aydin M, Yapar AF, Sert Y, Canpolat T, Aktas A. Preoperative evaluation of hyperparathyroidism: the role of dual-phase parathyroid scintigraphy and ultrasound imaging. Ann Nucl Med 2008; 22(2):123-31.
Younes NA, Hadidi AM, Mahafzah WS, Tarawneh ES, Al-Khatib YF, Sroujieh AS. Accuracy of single versus combined use of ultrasonography or computed tomography in the localization of parathyroid adenoma. Saudi Med J2008; 29(2):213-7.
Arnold J. Krubsack, Stuart D. Wilson, T. L. Lawson, B. David Collier, Robert S. Hellman and Ali T. Isitman. Prospective comparison of radionuclide, computed tomographic, and sonographic localization of parathyroid tumors. World Journal of Surgery, 1986;10(4).
| Files | ||
| Issue | Vol 49, No 8 (2011) | |
| Section | Original Article(s) | |
| Keywords | ||
| High resolution ultrasound Secondary hyperparathyroidism Chronic renal failure Hemodialysis | ||
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