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.