Clinical study of bone changes after parathyroidectomy among patients maintained by hemodialysis. Radiographic changes of alveolar bone and lamina dura using dental films and bone scintigraphy.:Radiographic changes of alveolar bone and lamina dura using d

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Thirteen patients maintained by hemodialysis with secondary hyperparatyroidism were mainly studied using Tc 99m-MDP bone scintigraphy and lamina dura index (LDI) which was judged by dental films. After parathyroidectomy (PTX), the most prominent change appeared on the calvaria, maxilla, and mandible in scintigrams. Intensity of Tc 99m-MDP accumulation was represented by using a quantitative method of bone-to-soft tissue uptake ratio (4 hr-B/St ratio). 4 hr-B/St ratio gradually decreased and became normal within one and a half years after PTX. The accumulation of Tc 99m-MDP on the calvaria may reveal the status of bone metabolism in the patients with secondary hyperparathyroidism. Also, LDIes gradually decreased during 4 through 6 months after PTX. However it was considered that these indexes might need a long term to return to normal range. We couldn't differenciate which method was superior in the diagnostic value for detecting early skeletal changes between roentogenograms and bone scintigraphy as a indicator of post-PTX bone improvement. However, bone scintigraphy should be added to conventional examinations for following the courses of patients that underwent PTX because this procedure has many other advantages.
社団法人日本口腔外科学会の論文