Contrast-Enhanced Approach to Parathyroid Lesions

Activity: Talk or presentation types › Oral presentation

Description

Despite the improvement in B-mode ultrasound (US) imaging quality, it may still be challenging to distinguish between different parathyroid lesions. The objective was to evaluate the findings of contrast-enhanced ultrasound (CEUS) in parathyroid lesions and to determine whether CEUS and CEUS post-processing can help to differentiate between hyperplastic and neoplastic parathyroid glands.. In this prospective study, 88 patients (18-83 years, F:M=74:14) with hyperparathyroidism were recruited before parathyroid surgery. Multiparametric ultrasound - US, Colour Doppler, Superb Microvascular Imaging (SMI), CEUS (SonoVue) images were acquired and quantitative postprocessing was performed (VueBox). Results were compared with postsurgical morphology.. The most common US characteristics of parathyroid adenoma (PA) vs hyperplasia (PH) were: well defined, hypoechoic lesions with increased echogenicity in centre (67% and 52%, respectively), cystic components (54% and 59%, respectively) with afferent vessel (93% for both), PA’s were larger on average (p=0.001). CEUS showed peripheral hypervascularity in early arterial phase (median=10s), quickly reaching peak contrast concentration (median=15s), following early washout (median=27s) in PA and homogenous dynamics in PH with rapid washout (p=0.001). The most prevalent morphological subtype of adenoma was chief-cell adenoma (79%, n=59). Number of adenomas (61% of oxyphil subtype) displayed different pattern - preponderantly central enhancement. Fall time was shorter in PH’s compared to PA’s (8s vs. 11s). CEUS sensitivity for parathyroid pathology prior to postprocessing vs after postprocessing – 90% vs 98.2% and specificity 72.2% vs 85.3% (p=0.1).. CEUS is valuable and powerful tool for the preoperative assessment of parathyroid pathology with high sensitivity and specificity in differentiation of parathyroid lesions, including subtypes of adenoma – majority of those are distinguished by peripheral uptake, central washout and slower hemodynamics, compared to hyperplasia with homogeneous enhancement and rapid washout, whereas oxyphilic adenomas showed predominantly central enhancement.
Period29 Mar 2023
Event titleRSU International Research Conference 2023: Knowledge for Use in Practice
Event typeConference
OrganiserRīga Stradiņš University
LocationRiga, LatviaShow on map
Degree of RecognitionInternational

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