Preview

Medical and Biological Problems of Life Activity

Advanced search

Results of ultrasonography of the parathyroid glands in patients with secondary hyperparathyroidism associated with chronic kidney disease

Abstract

The ultrasonic characteristics of the parathyroid glands were studied in 478 patients with CKD and 60 individuals in the comparison group. It has been established that the PTH 65 pg/ml corresponds to a PTG volume of 0,20 cm3; at PTH 185 pg/ml, the volume of the largest PTG is 0,31 cm3, the total volume is 0,33 cm3; for 500 pg/ml - 0,53 and 0,71 cm3, respectively; 1000 pg/ml - 0,88 and 1,31 cm3; 1500 pg / ml - 1,23 and 1,91 cm3. Insignificant differences in the size of the largest PTG and of the total PTG volume indicate that in SHPT there is a dominant PTG, the volume of which should be taken into account when making a clinical decision. The typical ultrasonic characteristics of hyperplastic PTG in SHPT were determined, in case of detection of which and the correspondence of the serum concentration of PTH to the volume of the visualized parathyroid tissue, further studies on imaging of the PTG are inappropriate. The limitations of the method are the presence of concomitant thyroid pathology, cases of PTG ectopia in areas inaccessible to ultrasound, as well as visualization of signs of hyperplastic parathyroid glands in 29,6% of cases in the absence of secondary hyperparathyroidism.

About the Authors

N. V. Karlovich
УО «Белорусский государственный медицинский университет»
Russian Federation


T. V. Mokhort
УО «Белорусский государственный медицинский университет»
Russian Federation


References

1. The EANM practice guidelines for parathyroid imaging / P. Petranović Ovčariček [et al.] // Eur. J. of Nucl. Med. and Mol. Imaging. - 2021. - Vol. 48, № 9. - P. 2801-2822.

2. Карлович, Н.В. Вторичный гиперпаратиреоз при хронической болезни почек: моногр. / Н.В. Карлович, Т.В. Мохорт; М-во здравоохранения Респ. Беларусь, Белорус. гос. мед. ун-т. - Минск: БГМУ, 2021. - 177 с.

3. The role of imaging techniques in the study of renal osteodystrophy / P. Ambrosoni [et al.] // Am J Med Sci. - 2000. - Vol. 320. - P. 90-95.

4. Secondary hyperparathyroidism: detection with I-123-Tc-99m-Sestamibi subtraction scintigraphy versus US / C. Jeanguillaume [et al.] // Radiology. - 1998. - Vol. 207. - P. 207-213.

5. Johnson, N.A. Parathyroid imaging: technique and role in the preoperative evaluation of primary hyperparathyroidism / N.A. Johnson, M.E. Tublin, J.B. Ogilvie // AJR. - 2007. - Vol. 188. - P. 1706-1715.

6. Magnetic resonance imaging (MRI) and technetium-99m-methoxyisonitrile (MIBI) scintigraphy to evaluate the abnormal parathyroid gland and PEIT efficacy for secondary hyperparathyroidism / A. Wada [et al.] // Radiat Med. - 1999. - Vol. 17. - P. 275-282.

7. KDIGO 2017 clinical practice guideline update for the diagnosis, evaluation, prevention, and treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) // Kidney Int. Suppl. - 2017. - Vol. 7, № 1. - P. 1-59.

8. Image diagnosis of parathyroid glands in chronic renal failure / H. Takagi [et al.] // Ann Surg. - 1983. - Vol. 198. - P. 74-79.

9. Sonography for early diagnosis of enlarged parathyroid glands in patients with secondary hyperparathyroidism / S. Takebayashi [et al.] // AJR. - 1987. - Vol. 148. - P. 911-914.

10. Kitaoka, M. Ultrasonographic diagnosis of parathyroid glands and percutaneous ethanol injection therapy / M. Kitaoka // Nephrol. Dial. Transplant. - 2003. - Vol. 18, suppl. 3. - P. iii27-iii30.

11. Ectopic and extranumerary parathyroid glands location in patients with hyperparathyroidism secondary to end stage renal disease / E.M. Gomes [et al.] // Acta Cir Bras. - 2007. - Vol. 22. - P. 105-109.

12. Comparison of histological findings and parathyroid scintigraphy in hemodialysis patients with secondary hyperparathyroid glands / H. Nishida [et al.] // Endocr J. - 2005. - Vol. 52. - P. 223-228.

13. Parathyroid variants: US evaluation / S.B. Randel [et al.] // Radiology. - 1987. - Vol. 165. - P. 191-194.

14. Preoperative evaluation of hyperparathyroidism: the role of dual-phase parathyroid scintigraphy and ultrasound imaging / A. Sukan [et al.] // Ann Nucl Med. - 2008. - Vol. 22. - P. 123-131.

15. Gooding, G.A. Use of color Doppler imaging in the distinction between thyroid and parathyroid lesions / G.A. Gooding, O.H. Clark // Am. J. of Surg. - 1992. - Vol. 164, № 1. - P. 51-56.

16. Primary hyperparathyroidism: review and recommendations on evaluation, diagnosis, and management. A Canadian and international consensus / A.A. Khan [et al.] // Osteoporos.Int. - 2017. - Vol. 28, № 1. - P. 1-19.

17. Определение референтного интервала паратгормона у пациентов с различными стадиями хронической болезни почек / Н. В. Карлович [и др.] // Весці Нац. акад. навук Беларусі. Сер. мед. навук. - 2021. - Т. 18, № 2. - C. 186-195.

18. Ultrasound patterns of parathyroid glands in chronic hemodialysis patients with secondary hyperparathyroidism / C. Vulpio [et al.] // Am. J. of Nephrol. - 2008. - Vol. 28, № 4. - P. 589-597.

19. Image diagnosis of parathyroid glands in chronic renal failure / H. Takagi [et al.] // Ann. of Surg. - 1983. - Vol. 198, № 1. - P. 74-79.

20. Результаты визуализации паращитовидных желез у пациентов с вторичным гиперпаратиреозом на фоне терминальной стадии хронической болезни почек / Н.В. Карлович [и др.] // ARS Medica. Искусство медицины. - 2011. - № 10. - С. 74-79.


Review

For citations:


Karlovich N.V., Mokhort T.V. Results of ultrasonography of the parathyroid glands in patients with secondary hyperparathyroidism associated with chronic kidney disease. Medical and Biological Problems of Life Activity. 2022;(2):78-86. (In Russ.)

Views: 94


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2074-2088 (Print)