PREOPERATIVE DIAGNOSIS OF PATHOLOGY OF THE PARATHYROID GLANDS BY RADIODIAGNOSIS METHODS

Abstract

Recently, surgeons have been using minimally invasive methods to treat parathyroid pathology. More selective surgical approaches are based on the accuracy of preoperative diagnostic techniques. Various radiation diagnostic methods are used to visualize the pathology of the parathyroid glands. Along with long-known techniques, new modalities are entering clinical practice. When choosing a diagnostic algorithm, the attending physician should be guided by the most clinically effective and economically feasible scheme.

Purpose of the study: to find the optimal diagnostic protocol for preoperative diagnosis of parathyroid gland pathology based on the available available data.

Conclusion. Preoperative imaging of the parathyroid glands continues to evolve with changes in old techniques and the emergence of new ones, although no one modality has a clear advantage. The choice of imaging algorithm is largely based on the availability of methods and the experience of specific diagnostic centers. Ultrasound diagnostics and planar scintigraphy have proven themselves and are most widely used. The combination of these methods remains the first line of diagnosis in preoperative imaging. However, there is no consensus on the choice between planar scintigraphy techniques: washout method or subtraction method. Replacing planar scintigraphy with SPECT/CT improves the detection of pathological formations and clarifies their topographic location. Computed tomography and magnetic resonance imaging are used as a second line and are advantageous for small-sized pancreatic adenomas, multiple lesions, ectopia, during repeated operations, as well as in the case of ambiguous ultrasound and scintigraphy data. The value of PET/CT in the diagnosis of PTG pathology has not yet been determined, data is still limited, and published results are very heterogeneous, but due to its excellent diagnostic characteristics, the method seems very promising, especially in patients with persistent disease.