RESUMEN
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.
Resumo O adenoma de paratireoide é a causa mais comum de hiperparatireoidismo primário. Com o avanço das técnicas cirúrgicas, na maioria das vezes é realizada a retirada apenas da paratireoide afetada. Para que isso seja possível, os exames de imagem têm papel fundamental. São utilizados para a localização das paratireoides exames como a cintilografia e a ultrassonografia, e recentemente a tomografia computadorizada quadridimensional (TC 4D) com protocolo específico. O objetivo deste ensaio é descrever o uso do protocolo TC 4D em casos de adenoma da paratireoide e determinar sua correlação com os outros métodos de imagem, para facilitar o entendimento do método.
RESUMEN
Objective: The purpose of this study was to evaluate the use of SPECT-CT for the determination of the anatomical locations of the cervical 131Iodine uptake areas during 131Iodine-whole body (131I-WB) scans. Methods: One hundred fifty-four patients who had undergone total thyroidectomyfor differentiated thyroid carcinoma (DTC) and had 131I-WB scan with cervical uptake images were studied with SPECT-CT, from March 2003 to October 2006. Results: From the 154patients included, 124 were women (80.5%) and the mean age of 46.09 ± 14.77 years. 131I-WB was performed 1-2 months after surgery in 137 patients (89.0%). The percentage of cervical uptake found varied between 0.1 and 15.0% and its mean was 1.42 ± 2.05%. Using SPECT-CT, 223 foci of cervical 131Iodine uptake (CIU) were identified in 154 patients. CIU foci were localized to the thyroid bed in 17 patients, while 29 patients presented with CIU in the thyroid bed and the extra thyroid tissue and in both the thyroid bed and extra thyroid tissues in another 29 patients. Inthe remaining 108 subjects, the CIU were located outside of the thyroid bed, of which the most common locations were the sternothyroid muscle and the thyroid cartilage. Conclusions: The useof SPECT-CT demonstrated significant diversity in the anatomical locations of CIU foci observed during 131I-WB scans after thyroidectomy for DTC