Mondragón-Sánchez A, Loker J, Salazar-Navarro F, Pattou F, Carnaille B, Huglo D, Proye C

Language: Spanish
References: 23
Page: 169-174
PDF size: 117.22 Kb.

ABSTRACT

Objective: To determine the usefulness of radio-guided surgery in the surgical treatment of primary hyperparathyroidism.
Setting: Third level health care hospital.
Patients and methods: Seventy-five patients with primary hyperparathyroidism were subjected to radioguided surgery during the first 90-180 minutes after intravenous injection of a diagnostic dose of sestamibi (MIBI) and attaining images in anterior and oblique projection. Exclusion criteria were: thyroid pathology requiring surgical treatment and suspicion of multiple endocrine neoplasms. A 20% increase from background activity to tissular uptake was interpreted as diagnostic for hyperfunctional parathyroid tissue.
Results: This detection method is technically delicate and up-take variations are considerable according to the angle of the probe. Our experience has revealed the existence of a physiological gradient between the upper and lower homolateral quadrants of the neck (from -8% to -17%) due to the proximity of mediastinal vessels. Eight of the 75 preoperative gammagraphies (11%) were negative, transoperative detection was useful only in three of the eight.
Conclusion: The contribution of the technique seems to be limited, however, its greatest usefulness might lie in cases of re-operation, when the hypersecreting gland is far from the sites of physiological uptake of the radioisotope.

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