摘要：Background : With the increasing adoption of minimally invasive parathyroidectomy techniques, the dual use of sestamibi scintigaphy (MIBI) and Ultrasound (US) has become more important in the preoperative evaluation of primary hyperthyroidism. The results presented here arose from a Practice Quality Improvement project (PQI) at our institution, which demonstrated that when compared against surgical outcomes, the use of both MIBI and US enhanced the detection of enlarged parathyroid glands. This project corroborates the complementary nature of these two imaging modalities in the preoperative localization of enlarged parathyroid glands. Methods : Fifty-six consecutive cases that coupled the usage of MIBI and US were included during the duration of our PQI project from January to November of 2014. Patients in every case were diagnosed with typical Primary Hyperparathyroidism (PHPT) accompanied by the elevation of Parathyroid Hormone (PTH) and calcium levels, with the exception of one case. Results : In 34 out of 56 cases, the parallel use of preoperative MIBI and US resulted in consistent findings between the two modalities. The remaining 22 cases demonstrated that the limitations of one modality can be overcome by the advantages of the alternate modality. Conclusion : MIBI provides guidance for the interpretation of US data, especially in the context of ectopic parathyroid glands, small parathyroid adenomas, and concurrent thyroid nodules. US offers detailed anatomic information and supports the diagnostic confidence of interpreting MIBI scans. US can be especially helpful in patients with more than one enlarged parathyroid gland. In the majority of cases, the dual utilization of MIBI and US was able to successfully overcome the inherent limitations of each modality when employed alone.
