Ernst Michael Jung MD, Presenter: Nothing to Disclose

Janine Rennert MD, Abstract Co-Author: Nothing to Disclose

Ayman Agha, Abstract Co-Author: Nothing to Disclose

Occasionally, preoperative localization in case of primary hyperparathyroidism (pHPT) turns out to be very difficult with negative impact on surgical success including increased risk for morbidity and persistence of symptoms. Here, we present contrast-enhanced ultrasonography (CEUS), a new diagnostic procedure to localize exactly parathyroid hyperfunction.

Between 8/2009 and 3/2010 20 patients with pHPT were operated in the University Hospital Regensburg. Laboratory values were measured and all patients received contrast-enhanced ultrasonography (CEUS) as well as conventional ultrasonography, mibi scintigraphy and magnetic resonance imaging (MRI). We analyzed the predictive capability of the different diagnostic procedures as well as their costs and expenditure of time. In addition, intra- and postoperative data are reported.

CEUS revealed highest sensitivity of 100% and came out on top as diagnostic method to localize parathyroid hyperfunction. Moreover, costs and expenditure of time were significantly reduced using CEUS compared to the other procedures. Overall, 18 patients underwent minimal invasive surgical intervention and solely two patients received conventional operation due to accompanying thyroid nodules. Operating time including waiting time for intraoperative parathyroid hormone averaged 49 minutes and the mean of adenoma size was 1.5 cm. Intraoperative parathyroid hormone of all patients dropped appropriately after removal of the adenomas. Six weeks after surgery all patients showed normal calcium and parathyroid hormone levels.

CEUS, performed by experienced investigator, represents an highly sensible and cost-efficient method for localization of parathyroid adenomas. In case of pHPT, if CEUS is positive, further investigations are not required. For the future, CEUS should be the standard diagnostic procedure to avoid surgical risks and medical costs.

CEUS, performed by experienced investigator, represents an highly sensible and cost-efficient method for localization of parathyroid adenomas.

Jung, E, Rennert, J, Agha, A, Role of Contrast-enhanced Ultrasonography (CEUS) in Detection of Primary Hyperparathyroidism: First Results.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9011094.html