Limitations of technetium 99m sestamibi scintigraphic localization for XXXX associated with @entity66 .

@entity1 @entity459 @entity66 @entity652 @entity2742 @entity461
Successful surgical treatment of @entity459 requires the localization and excision of the parathyroid tissue responsible for excessive @entity461 secretion while ensuring that the @entity1 will have sufficient endogenous @entity461 production to maintain eucalcemia. In selecting @entity1 with @entity459 for unilateral parathyroidectomy the surgeon should be able to diagnose @entity66 either preoperatively or intraoperatively. We performed a retrospective review of 123 @entity1 who underwent surgical treatment for @entity459 to determine the potential feasibility of selecting @entity1 for minimally invasive surgery based on preoperative imaging studies. All @entity1 were studied preoperatively with 99m technetium-sestamibi scintigraphy. High-resolution ultrasonography was performed in 119 of these @entity1 . All @entity1 except one underwent bilateral cervical exploration. A @entity1 with an intrathoracic @entity652 was successfully diagnosed by scintigraphy thereby allowing treatment by a limited thoracotomy. One hundred eight @entity1 had solitary @entity652 and 15 had @entity66 . In none of the @entity1 with bilateral @entity66 were all abnormal glands localized preoperatively. @entity1 in our study with primary @entity2742 were underdiagnosed by preoperative imaging. A minimally invasive approach based solely on preoperative imaging studies may result in treatment failure in @entity1 with multiglandular involvement.
