ULTRASOUND OF THE THYROID AND PARATHYROID GLANDS PDF
Thyroid ultrasound is easy to perform due to the superficial location of the thyroid gland, Keywords: thyroid gland, parathyroid glands, cervical lymph nodes. Ultrasound of the Thyroid and Parathyroid Glands Digitally watermarked, DRM- free; Included format: EPUB, PDF; ebooks can be used on all reading devices. V. SUPERVISION AND INTERPRETATION OF ULTRASOUND EXAMINATIONS. . thyroid and parathyroid glands and are based on the practice guidelines.
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The American Institute of Ultrasound in Medicine (AIUM) is a multi- disciplinary thyroid gland, parathyroid glands, and adjacent soft tissues. Occasionally, an. Request PDF on ResearchGate | Ultrasound of the Thyroid and Parathyroid Glands | Ultrasound plays a prominent role in the management of thyroid disease . PDF | Thyroid ultrasound is easy to perform due to the superficial location of the thyroid gland, but appropriate equipment is mandatory with a linear high.
Previously, radiologists played a limited role in the treatment of parathyroid disease, primary focusing on the preoperative localization of parathyroid lesions responsible for hyperparathyroidism. But, the widespread use of high-resolution ultrasound has lead to the increasing detection of parathyroid incidentalomas PTIs. Consequently, radiologists may be required to differentiate PTIs from thyroid lesions, which is most reliably accomplished through the fine needle aspiration-parathyroid hormone analysis. Various nonsurgical treatment modalities for hyperfunctioning parathyroid lesions have been developed with some efficacy. Especially for symptomatic nonfunctioning parathyroid cysts, simple aspiration is a first-line procedure for diagnosis and treatment, while ethanol ablation is a subsequent treatment modality for recurrent cases. The role of radiologists in the treatment of parathyroid disease was previously limited to the preoperative localization of hyperfunctioning parathyroid lesions [ 1 ]. However, radiologists have been required to play a more active role, because it is increasingly necessary to distinguish parathyroid incidentalomas PTIs detected during thyroid ultrasonography US , from thyroid lesions [ 2 - 5 ].
US-guided simple aspiration is the preferred technique for diagnosing nonfunctioning PCs [ 14 , 43 ]. The fluid aspirated from these cysts is usually clear and colorless [ 14 , 41 ]. Although simple aspiration has been used as an initial diagnosis and treatment for symptomatic nonfunctioning PCs, cases of recurrence after aspiration have been reported [ 14 , 43 , 44 ]. In patients with recurrent cysts, repeat aspiration, surgical excision, tetracycline treatment, and ethanol ablation EA have been performed [ 41 , 43 , 44 ].
In order to minimize ethanol leakage during EA of PCs, transisthmic approach should be employed, in which the needle is inserted through a sufficient amount of normal thyroid parenchyma Fig.
For symptomatic nonfunctioning PCs, simple aspiration is a first-line procedure for diagnosis and treatment, whereas EA is a subsequent treatment modality suitable for recurrent PCs. An axial sonogram shows the parathyroid cyst PC 6.
Parathyroid ultrasonography: the evolving role of the radiologist
The PC recurred two 2 months after simple aspiration. An axial sonogram shows the transisthmic approach of an gauge needle arrow into the PC. An axial sonogram shows the PC after it was filled with instilled ethanol via an gauge needle arrow after the complete evacuation of the cystic fluid. An axial sonogram shows the PC with a much smaller size 2. T, trachea; C, common carotid artery.
The conventional treatment of patients with primary HPT is neck surgery. Several nonsurgical treatment modalities have been developed to treat such patients. For over 20 years, EA has been used by specialists to treat patients with primary HPT as well as patients with secondary or tertiary HPT due to renal disease. The success rate of EA is inversely correlated with the size of the parathyroid tumor and the duration of follow-up.
However, side effects are common, including pain, vocal cord palsy, and extraparathyroid fibrosis, which would be likely to interfere with any possible subsequent surgery [ 6 , 13 ].
Ultrasound of the Thyroid and Parathyroid Glands
Since , laser thermal ablation has been suggested as a possible therapy, and has shown some efficacy in controlling serum levels of calcium and PTH in HPT patients [ 7 - 9 ].
Very limited information is available about the experiences of HPT patients treated by radiofrequency ablation, because only three case reports have been documented.
However, in all three reports, serum levels of PTH and calcium were reduced after ablation [ 10 , 11 ]. High-intensity focused ultrasound is a noninvasive ablative method based on the generation of extracorporeal ultrasound waves focused on target tissue [ 12 , 13 ].
Kovatcheva et al. EA, laser thermal ablation, radiofrequency ablation, and high-intensity focused ultrasound have been reported to show some efficacy in controlling serum calcium and PTH levels and in reducing the volume of the parathyroid. However, these treatments either involve some side effects or do not show evidence of good long-term efficacy [ 6 - 13 ]. More studies are needed to verify the utility and general applicability of these techniques. This article has described the role of radiologist in the diagnosis and the treatment of parathyroid lesions.
US examination plays an important role in patients with primary HPT in the preoperative localization of hyperfunctioning parathyroid lesions. More studies are needed to verify the utility of the nonsurgical treatment modalities that have been developed to treat hyperfunctioning parathyroid lesions.
No potential conflict of interest relevant to this article was reported. National Center for Biotechnology Information , U. Journal List Ultrasonography v. Published online Apr 6. Jin Yong Sung. Author information Article notes Copyright and License information Disclaimer. Correspondence to: This article has been cited by other articles in PMC.
Abstract Previously, radiologists played a limited role in the treatment of parathyroid disease, primary focusing on the preoperative localization of parathyroid lesions responsible for hyperparathyroidism. Parathyroid glands, Hyperparathyroidism, Incidental findings, Ablation techniques, Ultrasonography.
Introduction The role of radiologists in the treatment of parathyroid disease was previously limited to the preoperative localization of hyperfunctioning parathyroid lesions [ 1 ]. Normal Anatomy and US Examination of Parathyroid Glands Normal parathyroid glands are very small, measuring approximately 6 mm in the craniocaudal dimension and mm in the transverse dimension, with shape like a flattened disk.
Open in a separate window. A year-old woman with parathyroid adenoma. A year-old woman with parathyroid adenoma with characteristic feeding vessels. A year-old woman with very large nonfunctioning parathyroid cyst. Conclusion This article has described the role of radiologist in the diagnosis and the treatment of parathyroid lesions. Footnotes No potential conflict of interest relevant to this article was reported.
References 1. Lee JH, Anzai Y.
Imaging of thyroid and parathyroid glands. Semin Roentgenol. Parathyroid incidentaloma detected during thyroid sonography: Med Ultrason. Incidentalomas of the parathyroid gland: Endocr Pract. Parathyroid incidentalomas detected on routine ultrasound-directed fine-needle aspiration biopsy in patients referred for thyroid nodules and the role of parathyroid hormone analysis in the samples. Parathyroid hormone assay in fine-needle aspirate is useful in differentiating inadvertently sampled parathyroid tissue from thyroid lesions.
Modified percutaneous ethanol injection of parathyroid adenoma in primary hyperparathyroidism. Long-term effectiveness of ultrasound-guided laser ablation of hyperfunctioning parathyroid adenomas: Ultrasound-guided laser thermal ablation for parathyroid adenomas: Horm Res. Ultrasound guided laser ablation of a parathyroid adenoma. Br J Radiol. Treatment of secondary hyperparathyroidism with ultrasonographically guided percutaneous radiofrequency thermoablation.
Surg Laparosc Endosc Percutan Tech. High-intensity focused ultrasound as an alternative to the surgical approach in primary hyperparathyroidism: J Endocrinol Invest. US-guided high-intensity focused ultrasound as a promising noninvasive method for treatment of primary hyperparathyroidism.
Eur Radiol. Symptomatic nonfunctioning parathyroid cysts: Eur J Radiol. Anatomy and embryology of the thyroid and parathyroid glands. Feliciano DV. Parathyroid pathology in an intrathyroidal position. Am J Surg. Society for Pediatric Radiology. Society of Radiologists in Ultrasound AIUM practice guideline for the performance of a thyroid and parathyroid ultrasound examination. J Ultrasound Med.
Ultrasound of the Thyroid and Parathyroid Glands | Robert A. Sofferman | Springer
Imaging of the parathyroid glands. Accuracy of preoperative localization studies and intraoperative parathyroid hormone assay in patients with primary hyperparathyroidism and double adenoma. J Am Coll Surg. Clinical and surgical aspects of double adenoma in patients with primary hyperparathyroidism.
Br J Surg. Parathyroid carcinoma: J Clin Endocrinol Metab. National trends in parathyroid surgery from to Free Preview. Buy eBook. Buy Hardcover.
Buy Softcover. Rent the eBook. FAQ Policy. About this book This highly illustrated book, complete with comprehensive clinical references and annotated images, will serve as a leading text to educate head and neck surgeons, endocrinologists, and radiologists on the basics and nuances of thyroid and parathyroid ultrasound. Show all. Pages Ultrasound Surveillance Sofferman, Robert A.
Parathyroid Ultrasound Sofferman, Robert A.
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