Evaluation of blood supply to the parathyroid glands in secondary hyperparathyroidism compared with histopathology

• Published in: Nephrology, dialysis, transplantation Vol. 18; no. suppl-3; pp. iii34 - iii37
• Main Authors: Onoda, Noritaka, Kurihara, Satoshi, Sakurai, Yusei, Owada, Kazuhiro, Osono, Eiichi, Adachi, Hideki, Suga, Masaru, Yoneshima, Hideo
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Oxford Oxford University Press 01.06.2003
• Subjects: Biological and medical sciences; chronic renal failure; Endocrinopathies; Female; Humans; Hyperparathyroidism, Secondary - diagnostic imaging; Hyperparathyroidism, Secondary - pathology; Male; Medical sciences; Middle Aged; nodular hyperplasia; Non tumoral diseases. Target tissue resistance. Benign neoplasms; Organ Size; Parathyroid Glands - blood supply; Parathyroid Glands - diagnostic imaging; Parathyroid Glands - pathology; parathyroidectomy (PTx); Parathyroids. Parafollicular cells. Cholecalciferol. Phosphocalcic homeostasis (diseases); power‐Doppler ultrasonography; Regional Blood Flow; secondary hyperparathyroidism; Ultrasonography, Doppler, Color; Endocrinopathy; Sonography; Kidney disease; Human; Secondary; Urinary system disease; secondary hyperparathyroidism; Radiodiagnosis; chronic renal failure; Duplex ultrasonography; Focal nodular hyperplasia; parathyroidectomy (PTx); Anatomic pathology; Chronic; nodular hyperplasia; Histopathology; Treatment; power-Doppler ultrasonography; Parathyroid diseases; Etiology; Renal failure; Medical imagery; Selection criterion; Hyperparathyroidism
• ISSN: 0931-0509; 1460-2385; 1460-2385
• DOI: 10.1093/ndt/gfg1009

Background. In chronic renal failure patients, the parathyroid glands progress from diffuse hyperplasia to nodular hyperplasia, and it is important to distinguish between these as the latter form is more aggressive. This progress can be confirmed histologically, but the present study aimed to determine whether the different types of hyperplasia could be distinguished by power‐Doppler ultrasonography (US). Methods. Twenty‐one consecutive renal failure patients were scheduled to undergo parathyroidectomy (PTx). Of 70 resected parathyroid glands, 63 were assessed by pre‐operative power‐Doppler US, classified into four groups based on the flow signal pattern and then correlated with the post‐operative histopathology. Results. With power‐Doppler US imaging, 60.0% of glands without a signal inside the gland were diagnosed as diffuse hyperplasia or diffuse hyperplasia with early nodularity. Of glands with in‐gland signals, 83.7% were nodular or had a single nodule typical of nodular hyperplasia. Even when the focus was on parathyroid glands weighing ≤0.5 g, similar results were obtained. Conclusions. Power‐Doppler US imaging is a useful method for determining the pathological features of parathyroid glands and is recommended for selecting the most suitable therapy.