The diagnostic utility of computed tomography for preoperative localization in surgery for XXXX .

@entity8611 @entity1 @entity2742
OBJECTIVES/HYPOTHESIS: Successful unilateral or minimal-access parathyroid exploration and reoperative surgery of the parathyroid glands requires accurate preoperative localization of @entity8611 . Although ultrasound and nuclear imaging techniques have an established role in this regard, the use of computed tomography (CT) for parathyroid exploration is not well understood. The purpose of the present study was to better define the diagnostic utility of CT in preoperative localization of the abnormal gland in surgery for @entity2742 . STUDY DESIGN: Retrospective cohort study. METHODS: All parathyroid explorations performed at Oregon Health and Science University (Portland, OR) between 2000 and 2002 were reviewed. The study group was limited to @entity1 with @entity2742 in whom localization failed preoperatively using ultrasound and/or sestamibi scanning and subsequent investigation using CT imaging was performed. Operative, pathological, and imaging reports were then analyzed to assess the accuracy of CT imaging for localizing @entity8611 . RESULTS: Twenty-two @entity1 with @entity2742 were investigated preoperatively using CT imaging. Parathyroid exploration was successful in all but one @entity1 , leaving 21 @entity1 in all in the cohort. The majority of cases (67%) were reoperative, and all @entity1 had previously undergone inconclusive ultrasound and/or sestamibi scanning. Computed tomography correctly localized @entity8611 in 18 (86%) of the 21 @entity1 who underwent successful extirpation of @entity8611 and was able to identify abnormal glands with equal utility in the neck and the chest. CONCLUSION: When ultrasound or sestamibi are unsuccessful, CT imaging can provide valuable preoperative localizing information before surgery for @entity2742 , particularly in @entity1 with recurrent or persistent disease.
