Hypoparathyroidism CT

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Anmol Pitliya, M.B.B.S. M.D.[2]

Overview

Peripheral quantitative computed tomography (pQCT) and microcomputed tomography (microCT) may be helpful in the diagnosis of hypoparathyroidism. Findings on pQCT scan suggestive of hypoparathyroidism include increase in volumetric bone mineral density (vBMD) as well as bone mineral density (BMD) of both cortical and trabecular bones. Findings on microcomputed tomography include greater trabecular bone volume (BV/TV), markedly increased trabecular number (Tb.N) and trabecular thickness (Tb.Th); lower trabecular separation (Tb.Sp), and markedly elevated connectivity density (Conn D). A non-enhanced computed tomography of head may be helpful in the diagnosis of complications of hypoparathyroidism, which include bilateral and symmetrical intracranial calcifications in basal ganglia (mainly globus pallidus), cerebellum (dentate nuclei) and at the grey-white matter junction.

CT scan

Peripheral quantitative computed tomography (pQCT)

Microcomputed tomography (microCT)

  • Microcomputed tomography (microCT) may be helpful in the diagnosis of hypoparathyroidism.[3]
  • Findings on microCT scan suggestive of hypoparathyroidism include:
    • Greater trabecular bone volume (BV/TV)
    • Markedly increased trabecular number (Tb.N)
    • Markedly increased Trabecular thickness (Tb.Th)
    • Lower trabecular separation (Tb.Sp)
    • Markedly elevated connectivity density (Conn D)
    Note(1): A parameter that estimates the number of trabecular connections per millimeter cube is called connectivity density.

Non-enhanced computed tomography

  • A non-enhanced computed tomography of head may be helpful in the diagnosis of complications of hypoparathyroidism, which include bilateral and symmetrical intracranial calcifications in:[4]

References

  1. Chen Q, Kaji H, Iu MF, Nomura R, Sowa H, Yamauchi M, Tsukamoto T, Sugimoto T, Chihara K (2003). "Effects of an excess and a deficiency of endogenous parathyroid hormone on volumetric bone mineral density and bone geometry determined by peripheral quantitative computed tomography in female subjects". J. Clin. Endocrinol. Metab. 88 (10): 4655–8. doi:10.1210/jc.2003-030470. PMID 14557436.
  2. Cusano NE, Nishiyama KK, Zhang C, Rubin MR, Boutroy S, McMahon DJ, Guo XE, Bilezikian JP (2016). "Noninvasive Assessment of Skeletal Microstructure and Estimated Bone Strength in Hypoparathyroidism". J. Bone Miner. Res. 31 (2): 308–16. doi:10.1002/jbmr.2609. PMC 4832602. PMID 26234545.
  3. Rubin MR, Dempster DW, Kohler T, Stauber M, Zhou H, Shane E, Nickolas T, Stein E, Sliney J, Silverberg SJ, Bilezikian JP, Müller R (2010). "Three dimensional cancellous bone structure in hypoparathyroidism". Bone. 46 (1): 190–5. doi:10.1016/j.bone.2009.09.020. PMC 2818211. PMID 19782782.
  4. Mejdoubi M, Zegermann T (2006). "Neurological picture. Extensive brain calcification in idiopathic hypoparathyroidism". J. Neurol. Neurosurg. Psychiatr. 77 (12): 1328. doi:10.1136/jnnp.2006.098590. PMC 2077430. PMID 17110747.

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