Öz
Amaç
Bu çalışmanın amacı, sintigrafi ile tespit edilemeyen paratiroid lezyonlarının tespit edilmesinde dört boyutlu bilgisayarlı tomografinin (4D-CT) etkinliğini değerlendirmek, cerrahi bulgulara dayanarak gözden kaçan veya yanlış pozitif (FP) olarak değerlendirilen lezyonların sıklığını belirlemek ve bunların nedenlerini tanımlamaktır.
Yöntemler
Bu retrospektif çalışmanın popülasyonu, Ağustos 2022 ile Ocak 2024 arasında üniversitemizin hastanesinde hiperparatiroidizm teşhisi konan, sintigrafiye tabi tutulan ve negatif sintigrafi sonuçları üzerine 4D-CT taraması yapılan 44 hastadan oluşuyordu. Çalışma örneğine dahil edilen 38 hastanın demografik, laboratuvar ve klinik özellikleri ile görüntüleme sonuçları dahil olmak üzere bir dizi parametre analiz edildi. Hastaların 4D-CT ve cerrahi bulguları anormal paratiroid lezyonları açısından karşılaştırıldı.
Bulgular
Örneklemin ortalama yaşı 54,8±13,1 yıldı. Yirmi (%52,6) hasta asemptomatik, 18 (%47,4) hasta semptomatikti. 4D-CT görüntüleme sonuçları, 36 (%76,6) hastanın tanısının gerçek pozitif (TP), 5 (%10,6) hastanın false positives (FP) ve 6 (%12,8) hastanın yanlış negatif (FN) olduğunu gösterdi. true positive (TP), FP ve FN grupları arasında yaş, preoperatif kalsiyum seviyeleri, maksimum lezyon çapı ve lezyonun kısa-uzun eksen oranı açısından anlamlı farklılıklar vardı. Daha küçük lezyon boyutu, daha düşük preoperatif kalsiyum seviyeleri ve ileri yaş, daha yüksek FP ve FN sonuçları ile ilişkiliydi.
Sonuç
Sintigrafi negatif hiperparatiroidizmi olan hastalarda paratiroid lezyonlarını tespit etmede 4D-CT yüksek doğruluk göstermektedir. Preoperatif kalsiyum seviyeleri, yaş ve lezyon büyüklüğü gibi faktörler, tanısal sonuçları önemli ölçüde etkiler. Preoperatif değerlendirmeye 4D-CT’nin entegrasyonu, lezyon lokalizasyonunu geliştirerek cerrahi planlama ve yönetimi iyileştirebilir.
Anahtar Kelimeler: Dört boyutlu bilgisayarlı tomografi, primer hiperparatiroidizm, paratiroid adenomu, paratiroid hiperplazisi
Kaynakça
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