활동성 폐결핵환자의 부신기능에 관한 연구

Abstract

To compare the preoperative localization procedures, a total of 30 parathyroid tumors were scanned preoperatively using 99mTc-201Tl subtraction scan, high-resolution ultrasonography and computerized tomography (CT). Twenty-three cases of radionuclide scintigraphy, 20 cases of ultrasonography and 29 cases of CT have been taken in 22 cases of parathyroid adenoma, 3 cases of parathyroid hyperplasia and a case of parathyroid cancer.1) The sensitivities of parathyroid scintigraphy, sonography and CT in detecting parathyroid tumors were 86%, 60% and 74%, while the specificities of respective diagnostic modality were 92%, 92% and 98%. 2) Preoperative localization of parathyroid tumors appeared related not only to the volume of the tumor, but also to the position of the tumor. Ultrasonography and CT were not as sensitive as parathyroid scintigraphy in detecting the tumor located in the left lower lobe of parathyroid gland. 3) Common errors in localizing the tumors were easily made in cases with the volume of tumor less than 1 cm3, with the tumor surrounded by the normal architecture or the false tumor mimicking parathyroid gland, and with the abnormal thyroid gland nearby.Neck CT was a specific method for the preperative localization especially in case of the tumors involving more than 2 parathyroid gland. 99mTc-201Tl parathyroid scintigraphy was useful for the localization of parathyroid adenomas and hyperplastic glands and the sensitivity of it exceeded that of either ultrasonography or CT. It will be necessary to evaluate the applicability of the preoperative localization modalities extensively in case of, at least, hyperparathyroidism of the primary or persistent types. (J Kor Soc Endocrino 17:52~60, 1992)