Real-time imaging of ipsilateral parathyroid glands by retrograde injection of methylene blue into the superior thyroid artery: a new intraoperative parathyroid protection method
Abstract Background Postoperative hypoparathyroidism caused by parathyroid injury is a problem faced by thyroid surgeons. The current technologies for parathyroid imaging all have some defects. Methods Patients with differentiated thyroid carcinoma (DTC) who underwent unilateral thyroidectomy plus i...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-04-01
|
| Series: | BMC Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12893-024-02360-z |
| _version_ | 1827284516013604864 |
|---|---|
| author | Hanjie Guo Yuxing Zhang Saiyu Ren Xiaodong Yang Lei Tian Yun Huang Chaojun Zhang Xiliang Zhang |
| author_facet | Hanjie Guo Yuxing Zhang Saiyu Ren Xiaodong Yang Lei Tian Yun Huang Chaojun Zhang Xiliang Zhang |
| author_sort | Hanjie Guo |
| collection | DOAJ |
| description | Abstract Background Postoperative hypoparathyroidism caused by parathyroid injury is a problem faced by thyroid surgeons. The current technologies for parathyroid imaging all have some defects. Methods Patients with differentiated thyroid carcinoma (DTC) who underwent unilateral thyroidectomy plus ipsilateral central lymph node dissection were recruited. We dissected the main trunk of the superior thyroid artery entering the thyroid gland and placed the venous indwelling tube into the artery. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) were calculated. Results A total of 132 patients enrolled in this single-arm clinical trial, 105 of them completed retrograde catheterization via the superior artery. The sensitivity was 69.23 and 83.33% respectively. The specificity was 72.91 and 64.89%. The accuracy was 72.91 and 64.89%. The PPV was 85.71 and 81.08%. The NPV was 22.58 and 45.45%. There were no patients with allergic reactions to the methylene blue, or methylene blue toxicity. Conclusions Retrograde injection of methylene blue via the superior thyroid artery is an effective and safe method to visualize parathyroid glands. This method can accurately locate the target organ by ultraselecting the blood vessel and injecting the contrast agent while avoiding background contamination and reducing the amount of contrast agent. Trial registration Clinical trial registration numbers and date of registration: ChiCTR2300077263、02/11/2023. |
| first_indexed | 2024-04-24T09:56:43Z |
| format | Article |
| id | doaj.art-72ee63afd11c47fdaea8b1fc7bed73c8 |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-04-24T09:56:43Z |
| publishDate | 2024-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-72ee63afd11c47fdaea8b1fc7bed73c82024-04-14T11:06:40ZengBMCBMC Surgery1471-24822024-04-0124111010.1186/s12893-024-02360-zReal-time imaging of ipsilateral parathyroid glands by retrograde injection of methylene blue into the superior thyroid artery: a new intraoperative parathyroid protection methodHanjie Guo0Yuxing Zhang1Saiyu Ren2Xiaodong Yang3Lei Tian4Yun Huang5Chaojun Zhang6Xiliang Zhang7School of Medicine, South China University of TechnologyDepartment of General Surgery, The First Medical Center of PLA General HospitalSchool of Medicine, South China University of TechnologyDepartment of General Surgery, The First Medical Center of PLA General HospitalDepartment of General Surgery, The First Medical Center of PLA General HospitalDepartment of General Surgery, The First Medical Center of PLA General HospitalDepartment of General Surgery, The First Medical Center of PLA General HospitalDepartment of General Surgery, The First Medical Center of PLA General HospitalAbstract Background Postoperative hypoparathyroidism caused by parathyroid injury is a problem faced by thyroid surgeons. The current technologies for parathyroid imaging all have some defects. Methods Patients with differentiated thyroid carcinoma (DTC) who underwent unilateral thyroidectomy plus ipsilateral central lymph node dissection were recruited. We dissected the main trunk of the superior thyroid artery entering the thyroid gland and placed the venous indwelling tube into the artery. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) were calculated. Results A total of 132 patients enrolled in this single-arm clinical trial, 105 of them completed retrograde catheterization via the superior artery. The sensitivity was 69.23 and 83.33% respectively. The specificity was 72.91 and 64.89%. The accuracy was 72.91 and 64.89%. The PPV was 85.71 and 81.08%. The NPV was 22.58 and 45.45%. There were no patients with allergic reactions to the methylene blue, or methylene blue toxicity. Conclusions Retrograde injection of methylene blue via the superior thyroid artery is an effective and safe method to visualize parathyroid glands. This method can accurately locate the target organ by ultraselecting the blood vessel and injecting the contrast agent while avoiding background contamination and reducing the amount of contrast agent. Trial registration Clinical trial registration numbers and date of registration: ChiCTR2300077263、02/11/2023.https://doi.org/10.1186/s12893-024-02360-zParathyroid glandsMethylene blueSuperior thyroid arteryIntraoperative parathyroid protection |
| spellingShingle | Hanjie Guo Yuxing Zhang Saiyu Ren Xiaodong Yang Lei Tian Yun Huang Chaojun Zhang Xiliang Zhang Real-time imaging of ipsilateral parathyroid glands by retrograde injection of methylene blue into the superior thyroid artery: a new intraoperative parathyroid protection method BMC Surgery Parathyroid glands Methylene blue Superior thyroid artery Intraoperative parathyroid protection |
| title | Real-time imaging of ipsilateral parathyroid glands by retrograde injection of methylene blue into the superior thyroid artery: a new intraoperative parathyroid protection method |
| title_full | Real-time imaging of ipsilateral parathyroid glands by retrograde injection of methylene blue into the superior thyroid artery: a new intraoperative parathyroid protection method |
| title_fullStr | Real-time imaging of ipsilateral parathyroid glands by retrograde injection of methylene blue into the superior thyroid artery: a new intraoperative parathyroid protection method |
| title_full_unstemmed | Real-time imaging of ipsilateral parathyroid glands by retrograde injection of methylene blue into the superior thyroid artery: a new intraoperative parathyroid protection method |
| title_short | Real-time imaging of ipsilateral parathyroid glands by retrograde injection of methylene blue into the superior thyroid artery: a new intraoperative parathyroid protection method |
| title_sort | real time imaging of ipsilateral parathyroid glands by retrograde injection of methylene blue into the superior thyroid artery a new intraoperative parathyroid protection method |
| topic | Parathyroid glands Methylene blue Superior thyroid artery Intraoperative parathyroid protection |
| url | https://doi.org/10.1186/s12893-024-02360-z |
| work_keys_str_mv | AT hanjieguo realtimeimagingofipsilateralparathyroidglandsbyretrogradeinjectionofmethyleneblueintothesuperiorthyroidarteryanewintraoperativeparathyroidprotectionmethod AT yuxingzhang realtimeimagingofipsilateralparathyroidglandsbyretrogradeinjectionofmethyleneblueintothesuperiorthyroidarteryanewintraoperativeparathyroidprotectionmethod AT saiyuren realtimeimagingofipsilateralparathyroidglandsbyretrogradeinjectionofmethyleneblueintothesuperiorthyroidarteryanewintraoperativeparathyroidprotectionmethod AT xiaodongyang realtimeimagingofipsilateralparathyroidglandsbyretrogradeinjectionofmethyleneblueintothesuperiorthyroidarteryanewintraoperativeparathyroidprotectionmethod AT leitian realtimeimagingofipsilateralparathyroidglandsbyretrogradeinjectionofmethyleneblueintothesuperiorthyroidarteryanewintraoperativeparathyroidprotectionmethod AT yunhuang realtimeimagingofipsilateralparathyroidglandsbyretrogradeinjectionofmethyleneblueintothesuperiorthyroidarteryanewintraoperativeparathyroidprotectionmethod AT chaojunzhang realtimeimagingofipsilateralparathyroidglandsbyretrogradeinjectionofmethyleneblueintothesuperiorthyroidarteryanewintraoperativeparathyroidprotectionmethod AT xiliangzhang realtimeimagingofipsilateralparathyroidglandsbyretrogradeinjectionofmethyleneblueintothesuperiorthyroidarteryanewintraoperativeparathyroidprotectionmethod |