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Урологическая заболеваемость в Нижегородской области Стресс, метаболический синдром и хроническая болезнь почек TVT - 10 лет в России
Eksperimental'naya i klinicheskaya urologiya

Modern methods of visualization of the parathyroid glands in patients with urolithiasis associated with primary hyperparathyroidism

Number №4, 2019 - page 48-54
DOI: 10.29188/2222-8543-2019-11-4-48-54
For citation: Konstantinova O.V., Prosyannikov M.Yu., Grebenkin M.V., Sivkov A.V. Modern methods of visualization of the parathyroid glands in patients with urolithiasis associated with primary hyperparathyroidism. Experimental and clinical urology 2019;(4):48-54
Konstantinova O.V. Prosyannikov M.Yu. Grebenkin M.V. Sivkov A.V.
Information about authors:
  • Konstantinova O.V. – Dr.Sc., Chief Researcher for Urolithiasis of N.A. Lopatkin Scientific Research Institute of Urology and Interventional Radiology – Branch of the National Medical Research Radiological Centre of the Ministry of Health of Russian Federation, konstant-ov@yandex.ru, ORCID 0000-0002-2214-7543;
  • Prosyannikov M.Yu. – PhD, Head of Department of urolithiasis of N.A. Lopatkin Scientific Research Institute of Urology and Interventional Radiology – Branch of the National Medical Research Radiological Centre of the Ministry of Health of Russian Federation, prosyannikov@gmail.com, ORCID 0000-0003-3635-5244;
  • Grebenkin M.V. – Researcher at the Department of urolithiasis of N.A. Lopatkin Scientific Research Institute of Urology and Interventional Radiology – Branch of the National Medical Research Radio- logical Centre of the Ministry of Health of Russian Federation, mv.grebenkin@gmail.com
  • Sivkov A.V. – PhD, assistant director of N.A. Lopatkin Scientific Research Institute of Urology and In- terventional Radiology – Branch of the National Medical Research Radiological Centre of the Ministry of Health of Russian Federation, uroinfo@yandex.ru, ORCID 0000-0001-8852-6485
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Introduction. Urolithiasis is one of the most common urological diseases. One of the risk factors for the development and frequent recurrence of urolithiasis is primary hyperparathyroidism. Urolithiasis of hyperparathyroid etiology has a severe course: rapid stone growth is noted, as a rule, this is a bilateral process that requires repeated surgical intervention. Untimely diagnosis of this disease can lead to late surgical treatment and the development of severe and irreversible complications in patients.

Purpose. To analyze modern imaging methods of the parathyroid glands in patients with urolithiasis associated with primary hyperparathyroidism, and identify the most sensitive of them.

Materials and methods. To solve this goal, the literature databases e-Library and PubMed were used. Literary sources of 9 domestic and 34 foreign authors were studied.

Incidence. Primary hyperatrathyroidism is one of the most common endocrine diseases and is one of the risk factors for urolithiasis and nephrocalcinosis. About 4 million people suffering from primary hyperparathyroidism are identified annually in the world. According to foreign studies, PHGT is more often detected in women than in men, and prevalence increases as the diagnosis develops. Clinical manifestations. Increased secretion of parathyroid hormone contributes to increased osteolysis and loss of calcium by bone tissue, increased absorption of calcium from the intestine, leading to hypercalcemia, as well as increased levels of calciuria and phosphaturia, which is one of the risk factors for urolithiasis.

Laboratory diagnostics. The diagnosis of PHGT is based only on laboratory examination data. The diagnosis of PHGT can be considered confirmed in the presence of hypercalcemia in combination with a persistent increase in the level of PTH or in combination with the upper limit of the normal level of PTH. Modern imaging methods of the parathyroid glands. The analysis of modern diagnostic methods used to visualize the parathyroid glands is carried out. The characteristics and optimal situations of their use in determining the localization of the parathyroid glands and their structural disorders are described.

Conclusions. Modern methods of imaging of the parathyroid glands have been studied, the differences between clinical and laboratory manifestations in patients with urolithiasis diseaseon the background of PHPT and without PHPT are described. The data analyzed indicate the advantage of the 3T MRI method over other imaging methods, however, given the small groups of patients in the ongoing studies, it is necessary to continue the study of this method in order to determine its true diagnostic value.

Conflict of interest. The authors declare no conflict of interest.

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Keywords: primary hyperparathyroidism, nephrolithiasis, ultrasonography, computed tomography, magnetic resonance imaging, scintigraphy