Percutaneous Ultrasound-Guided Laser Ablation with Contrast-Enhanced Ultrasonography for Hyperfunctioning Parathyroid Adenoma: A Preliminary Case Series

Figure 1

Representative ultrasonography images from one patient, a 45-year-old woman with parathyroid adenoma and hyperparathyroidism, illustrating the LA procedure. (a) Longitudinal section of the right neck revealed a 0.21 mL enlarged parathyroid gland (arrow and cursors) situated posterior to the inferior portion of the right lobe of the thyroid gland. (b) Preablation CEUS demonstrated hyperenhancement of the parathyroid lesion. (c) Ultrasonography image showing a 21-gauge needle inserted into the parathyroid; the arrows point to the needle tip. (d) During the LA procedure, the tissue around the fiber tip became hyperechoic (arrows) under US monitoring, and the hyperechoic area gradually enlarged until the nodule became filled with hyperechogenicity. This LA process was repeated throughout the parathyroid gland until most of gland had been ablated. (e) The color Doppler image obtained 1 hour after ablation showed no flow signal in the ablated area (arrows). (f) After the procedure had been completed, CEUS showed no enhancement of the ablated area by the contrast agent (arrow).

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