IS THERE
ANY ROLE FOR CROSS-SECTIONAL IMAGING IN PRIMARY HYPERPARATHYROIDISM (PHPT)?
Neck
ultrasonography and Tc99m-sestamibi scan are the two basic imaging methods for
the preoperative investigation of the patient with PHPT. Cross-sectional
imaging (computed tomography [CT] and/or Magnetic Resonance Imaging [MRI]) are
no routinely indicated and should be selectively used, mainly when a
mediastinal lesion (adenoma) is detected on sestamibi scan. Cross sectional
imaging will provide the surgeon important information regarding the anatomic
relationships of the lesion with the adjacent organs/structures and will
facilitate the surgeon in selecting the optimal surgical approach (i.e.
resection through a cervical incision, or sternotomy or [very rarely]
thoracotomy).
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