일차성 및 이차성 부갑상선 기능항진증에서 초음파 검사의 유용성

Abstract

PURPOSE:To evaluate the accuracy and ultrasonographic findings of primary and secondary hyperparathyroidism (HPT) and correlate them with pathologic results. MATERIALS and METHODS: We reviewed 31 cases of surgically confirmed primary (n=22) and secondary (n=9) hyperparathyroidism. We used 10 or 7.5 MHz linear transducer and reviewed the location, contour, size and echogenicity of lesions. Then we evaluated the detection rate of parathyroid lesions based on surgical result and compared the result of 99mTc-sestamibi scan (15 cases). RESULTS: Location of primary HPT was left lower in 9, left upper in 5, right lower in 4, right upper in 3, left mid portion in 1 and superior mediastinum in 1. Lesions showed variable echogenicity -- mild low echo (2), moderate low echo (10), severe low echo (2), isoecho (4) and heterogeneous echo pattern (1). All the lesions except 5 were well defined and 3 lesions had echogenic rim. Posterior enhancement and lateral shadowing were noted in 3 and 4 lesions, respectively. Nineteen of 23 primary lesions were detected by ultrasonography (82.6%) and well correlated with sestamibi scan. In cases of secondary HPT, most were well defined low echoic nodular lesions, and we could detect 6 of 9 patients (67%) and 15 of 36 lesions (41.7%). Only 6 of 24 secondary lesions were detected by sestamibi scan (25%). CONCLUSION: The detection rate of ultrasonography in primary HPT was fairly good and well correlated with the result of the 99m Tc-sestamibi scan, but both diagnostic modalities were not promising in secondary HPT.