Abstract
Recently the number of patients with renal osteodystrophy due to secondary hyperparathyroidism has been increasing among long-term hemodialysis cases. We performed subtotal parathyroidectomies on 40 patients (15 males, 25 females). Their ages were 24-36 years and their hemodialysis histories were 52-163 months. Scintigraphy of the parathyroid glands was performed on all the patients before and after the operation. The scintigraphy was performed by the computer-assisted sugtraction technique with 201 TI and a radioisotope of I.
The results were as follows: There were 75 true positives, 7 false positives, 67 false negatives, and 18 true negatives. The sensitivity was 53%, the specificity was 72%, and the predictive value was 91%. In 52 of 76 (68%) excised parathyroid glands weighing more than 500mg, hyperparathyroidism was detected before the operation. In 23 of 66 (35%) excised parathyroid glands weighing less than 500mg, the condition was detected before the operation. One of the false positive findings was a papillary carcinoma of the thyroid glands. Scintigraphy was also useful in the postoperative follow-up study.
These results suggest that scintigraphy of the parathyroid glands in patients with renal osteodystrophy is valuable for localization, diagnosis of secondary hyperparathyroidism, and postoperative follow-up study.
