Sonography in primary hyperparathyroidism: review with emphasis on scanning technique.
OBJECTIVE
To review the sonographic features and focused sonographic scanning techniques that may assist in the preoperative localization of parathyroid adenomas in patients with primary hyperparathyroidism.


METHODS
The sonographic findings were reviewed in 54 of 58 consecutive patients with pathologically proven parathyroid adenomas. A systematic scanning approach including real-time gray scale, color and power Doppler, and graded compression gray scale imaging was used in all patients.


RESULTS
Fifty-four (93%) of 58 proven adenomas were correctly identified by sonography. Gray scale imaging alone was sufficient for identifying 26 (100%) of 26 large (> or =1-cm) and 3 (11%) of 25 small (<1-cm) parathyroid adenomas. However, for 25 (89%) of 28 small adenomas, a combination of color and power Doppler and graded compression real-time gray scale imaging was required for sonographic localization and identification.


CONCLUSIONS
Knowledge of typical locations and characteristic imaging features, as well as a systematic scanning approach, can result in accurate preoperative sonographic localization of parathyroid adenomas.
Reeder
Scott B
SB
Department of Radiology, Stanford University Medical Center, California 94304, USA.
Desser
Terry S
TS
Weigel
Ronald J
RJ
Jeffrey
R Brooke
RB
D000236:Adenoma / Q000098:blood supply / Q000000981:diagnostic imaging*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000000981:diagnostic imaging* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010282:Parathyroid Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging*; D013961:Thyroid Gland / Q000000981:diagnostic imaging; D014463:Ultrasonography / Q000379:methods*; D018615:Ultrasonography, Doppler, Color