Computed tomography of the parathyroids: The value of density measurements to distinguish between parathyroid adenomas of the lymph nodes and the thyroid parenchyma - 20/07/12
Abstract |
Purpose |
To compare the densities of parathyroid adenomas, lymph nodes and the thyroid parenchyma during multi-phase cervico-thoracic computed tomography to determine the differentiating threshold values.
Materials and methods |
This study comprises 30 patients operated for a parathyroid adenoma after computed tomography without injection and then 45 and 70seconds after the injection of an iodine based contrast product (350mgI/mL, 150mL, 3mL/s). The density of the adenomas, lymph nodes and thyroid was measured during the three phases (D0, D45, D70). The relative enhancement (RE) at 45seconds was calculated: RE=(D45–D0)/D0.
Results |
A significant difference was found in the spontaneous density of the parathyroid adenomas of the thyroid (P<0.01) with a threshold value of 75 HU. A significant difference is found in the enhancement after injection of the adenomas and lymph nodes (P<0.01). The adenomas present an enhancement peak at 45seconds while the maximum enhancement of the lymph nodes is at 70seconds. At 45seconds, a threshold value of 114HU and an RE 125% allows them to be distinguished (sensitivity and specificity 0.96).
Conclusion |
Measurement of the densities can differentiate between the parathyroid adenomas, lymph nodes and thyroid.
Le texte complet de cet article est disponible en PDF.Keywords : 4D computed tomography, Hyperparathyroidism, Computed tomography, Parathyroid glands, Parathyroid tumours
Plan
Vol 93 - N° 7-8
P. 597-603 - juillet 2012 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.