[Comparison between direct radiographic enlargement and mammography technique in detection of osseous changes of the hand skeleton in hyperparathyroidism].

PURPOSE: To compare direct magnification radiography and mammographic film-screen systems in osseous changes of the hand in hyperparathyroidism.

MATERIALS AND

METHODS

The hands of 60 patients who were suspected to have primary (5), secondary or tertiary (both 55) hyperparathyroidism were evaluated with direct magnification radiography and a mammographic film-screen system (S12.5). Posterior-anterior views of each hand were obtained with both techniques. The magnification radiographs were made with a focal spot size of 40 or 60 microns, digital luminescence radiography (S600/1200), and a x 6 or 8 magnification. The 240 films were evaluated for subperiosteal, intracortical and endosteal resorptive changes by five radiologists using a grading according to five levels of confidence.

RESULTS

A significant improvement (p < 0.05) in the diagnosis of periosteal and intracortical bone resorption was shown, but no significant changes in endosteal resorption with direct magnification radiography. As compared to mammographic film-screen systems, magnification radiography improved the diagnostic accuracy (24%). The time needed for the evaluation of periosteal and intracortical bone resorption was shortened with direct magnification radiography (-4%/ -15%), and the time for giving the diagnosis decreased (-10%).