Abstract
Parathyroid adenoma is the most common cause of primary hyperparathyroidism. Advances in surgical techniques have made it possible to excise only the affected parathyroid gland in most cases. Imaging examinations play a fundamental role in the preoperative planning of parathyroidectomy. To localize the parathyroid glands, imaging tests such as scintigraphy, ultrasound, and, more recently, four-dimensional computed tomography (4D CT). The aim of this pictorial review was to illustrate the use of the 4D CT protocol in cases of parathyroid adenoma and to determine how well it correlates with other imaging methods, in order to improve understanding of the 4D CT method.
Highlights
Hyperparathyroidism is a condition caused by an increase in parathormone, a hormone responsible for the release of calcium from tissues into the plasma, either by stimulating osteolytic activity in osteoblasts or by stimulating bone resorption of phosphorus, which contributes to demineralization
We reviewed the cases of parathyroid adenoma among the case records at our hospital, selecting those in which the 4D CT protocol was used in order to evaluate adenomas and parathyroid hyperplasia, as well as comparable images obtained through other imaging methods
In the 4D CT protocol for parathyroid evaluation, the third dimension refers to the various reconstruction planes and the fourth dimension refers to time
Summary
Hyperparathyroidism is a condition caused by an increase in parathormone, a hormone responsible for the release of calcium from tissues into the plasma, either by stimulating osteolytic activity in osteoblasts or by stimulating bone resorption of phosphorus, which contributes to demineralization. When surgical treatment of hyperparathyroidism began to be implemented, most procedures involved removal of all of the parathyroid glands, because it was not possible to know which gland was affected by adenoma or even to know the precise location of each gland This procedure was associated with high morbidity, in addition to not always being effective, because anatomical variations and the potential for ectopic parathyroid glands resulted in high rates of recurrence[2,3]. Nagano SYM et al / 4D CT protocol for evaluation of the parathyroid glands parameters and parathormone levels, it is not always necessary to remove the others[4] Some imaging methods, such as ultrasound and technetium-99m-sestamibi (99mTc-sestamibi) scintigraphy, play a well-established role in the preoperative localization of the parathyroid glands. We reviewed the cases of parathyroid adenoma among the case records at our hospital, selecting those in which the 4D CT protocol was used in order to evaluate adenomas and parathyroid hyperplasia, as well as comparable images obtained through other imaging methods
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