Radiology, Vol 186, 255-257, Copyright © 1993 by Radiological Society of North America
Diagnosis of hyperparathyroidism with US after autotransplantation: results of a prospective study
F Winkelbauer, ME Ammann, F Langle and B Niederle
Department of Radiology, University of Vienna, Austria.
The best treatment for reactive hyperparathyroidism, a complication of
chronic renal failure, consists of resection of all four parathyroid glands
and subsequent autotransplantation of parathyroid fragments into the
brachioradialis muscle of the forearm. These procedures normalize the
elevated parathyroid metabolism in at least two-thirds of the patients. In
this prospective study, the parathyroid transplant was examined at least
once with ultrasound (US) during postoperative follow- up for a maximum of
84 months in 22 women and 13 men who were undergoing long-term hemodialysis
for reactive hyperparathyroidism. In 32 of these 35 patients, the
graft-bearing forearm had a normal appearance on US scans. Three patients
had one or two hypoechoic lesions 5-11 mm in diameter. Graft-dependent
recurrent hyperparathyroidism was verified in two of these patients by
means of clinical, biochemical, and histologic examination. It is concluded
that US is effective in the recognition and localization of graft-dependent
recurrent hyperparathyroidism.
