Developmenth of the ultrasound device for thr preoperative lacalization of parathyroid tumor

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We developed 3 types of mechanical sector scamer to predict the localization of parathyorid tumor:type I, II and III. Both of type and II are 7.5 MHz scanners;typeIII 10 MHz scanner. Type I had a 2 cn focal distance with water bag at the scanhead. The typeII consisted of a 3 cm focal distance and polyethylen protruding scanhead. On the other hand, the focal distance of typeIII (10 MHz) with water bag scanheas was 1 cm.All scanners were equiped with the ultrasonic real-time guidance system(Aloka SSD-125^r). Ultrasonographic investigations were performed in 6 cases of primary hyperparathyroidism (PHP) and 4 parients with secondary hyperparathyroidism (SHP). In these saces, computed tomography (CT) and scintigraphy(^<201> TL) were carried out,too.Among 3 types of scanner,typeII was mainly used,since this type gave the most clear picture and typell was operated easily. TypeII was namely the bast.Compared with conventinal electronic real-time linear scanner of 5 MHz,typell depicted more clearly abnormal parathyroid glands and could detect smaller senoma or hyperplasia.The predictability by ultrasonography (US),CT and RI was evaluated compared with operative findings,respctively. The preoperative localization of 6 parathyoid adenomas and 14 hypertrophied parathyroid glands were examined. In 4 parathyroid gland under 0.5g of weighr, the diagnostic accuracy of US was 75%, while that of CT was 50% and no gland was detected by RI. In 6 parathyroid gland from 0.5g to 1.0g the predictability was 50% by US,17%by CT and 33% by RI.As to 10 parathroid gland over 1.0g, the diagnotsic accuracy of US,CT,and RI was 90%,70%and 70%, respectively. US had the higher overall sensitivity than CT and RI. The minimum weight of the detectable parathyroid gland was 150mg,150mg and 500mg by US,CT and RI,respctively.Ultrasonography during the operation did not give the picture of parathyroid gland clearly. Similarly,the percutaneoud parathyroid diopsy guided by US was not successful.