Abstract：
Our rationale was to review the imaging options for patients with primary hyperparathyroidism and to advocate for judicious use of 4-dimensional (4D) SPECT/CT to visualize diseased parathyroid glands in patients with complex medical profiles or in whom other imaging modalities fail. We review the advantages and disadvantages of traditional imaging modalities used in preoperative assessment of patients with primary hyperparathyroidism: ultrasound, SPECT, and 4D CT. We describe a scheme for optimizing and individualizing preoperative imaging of patients with hyperfunctioning parathyroid glands using traditional modalities in tandem with 4D SPECT/CT. Using the input from radiologists, endocrinologists, and surgeons, we apply patient criteria such as large body habitus, concomitant multiglandular disease, multinodular thyroid disease, confusing previous imaging, and unsuccessful previous surgery to create an imaging paradigm that uses 4D SPECT/CT yet is cost-effective, accurate, and limits extraneous radiation exposure. 4D SPECT/CT capitalizes on the strengths of SPECT and 4D CT and addresses limitations that exist when these modalities are used in isolation. In select patients with complicated clinical parameters, preoperative imaging with 4D SPECT/CT can improve accuracy yet remain cost-effective.
摘要：
我们的理由是回顾原发性甲状旁腺功能亢进症患者的影像学选择，并提倡明智地使用4维（4D）SPECT/CT来可视化具有复杂医学特征或其他影像学检查失败的患者的患病甲状旁腺。我们回顾了用于原发性甲状旁腺功能亢进症患者术前评估的传统成像方式的优缺点：超声，SPECT,4DCT我们描述了一种使用传统模式与4DSPECT/CT串联优化和个性化甲状旁腺功能亢进患者术前成像的方案。利用放射科医生的输入，内分泌学家,和外科医生，我们应用患者标准，如体型大，伴随的多腺体疾病，甲状腺多结节性疾病,混淆以前的成像，和不成功的先前手术，以创建一个成像范例，使用4DSPECT/CT，但具有成本效益，准确,并限制外来辐射暴露。4DSPECT/CT利用了SPECT和4DCT的优势，并解决了孤立使用这些模态时存在的局限性。在选择具有复杂临床参数的患者中，术前使用4DSPECT/CT成像可以提高准确性，但仍具有成本效益。
