Аннотация:Objective The present study was designed to evaluate 4D computerized tomography (CT) as a means of localizing abnormal parathyroid glands in primary hyperparathyroidism (HPT). Study Design Case series with expertized image review. Setting Tertiary care hospital. Subjects and Methods A total of 38 patients were recruited for study, all of whom had undergone focused parathyroidectomy for single‐lesion primary HPT between June 2011 and September 2013. In each patient, 3 imaging procedures were performed: cervical ultrasonography (US), 99m Tc‐sestamibi SPECT/CT (SeS), and 4D CT. Collective imaging data were blindly reviewed and compared. Results 4D CT outperformed US and SeS in terms of sensitivity ( P =. 27), specificity ( P =. 01), positive predictive value (PPV) ( P <. 01), negative predictive value (NPV) ( P =. 19), and accuracy ( P <. 01). In 7.9% (3/38) of patients, 4D CT provided specific anatomic information that was unaffordable by US and SeS. Localization by 4D CT correlated with tissue parathyroid hormone level ( P =. 02), maximum diameter ( P =. 01), and volume ( P <. 01) of abnormal parathyroid glands. Conclusion 4D CT proved helpful in localizing target parathyroid glands of primary HPT that were missed by traditional imaging.
