title: Evaluation of blood supply to the parathyroid glands in secondary hyperparathyroidism compared with histopathology.
abstract: BACKGROUND
  In chronic renal failure patients, the parathyroid glands progress from diffuse hyperplasia to nodular hyperplasia, and it is important to distinguish between these as the latter form is more aggressive. This progress can be confirmed histologically, but the present study aimed to determine whether the different types of hyperplasia could be distinguished by power-Doppler ultrasonography (US).
  
  
  METHODS
  Twenty-one consecutive renal failure patients were scheduled to undergo parathyroidectomy (PTx). Of 70 resected parathyroid glands, 63 were assessed by pre-operative power-Doppler US, classified into four groups based on the flow signal pattern and then correlated with the post-operative histopathology.
  
  
  RESULTS
  With power-Doppler US imaging, 60.0% of glands without a signal inside the gland were diagnosed as diffuse hyperplasia or diffuse hyperplasia with early nodularity. Of glands with in-gland signals, 83.7% were nodular or had a single nodule typical of nodular hyperplasia. Even when the focus was on parathyroid glands weighing <or=0.5 g, similar results were obtained.
  
  
  CONCLUSIONS
  Power-Doppler US imaging is a useful method for determining the pathological features of parathyroid glands and is recommended for selecting the most suitable therapy.
authors.affiliation: Division of Nephrology, Kasukabe Shuwa Hospital, Saitama, Japan. onoda@ksh.smds.co.jp
authors.forename: Noritaka
authors.initials: N
authors.lastname: Onoda
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kurihara
authors.forename: Yusei
authors.initials: Y
authors.lastname: Sakurai
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Owada
authors.forename: Eiichi
authors.initials: E
authors.lastname: Osono
authors.forename: Hideki
authors.initials: H
authors.lastname: Adachi
authors.forename: Masaru
authors.initials: M
authors.lastname: Suga
authors.forename: Hideo
authors.initials: H
authors.lastname: Yoneshima
mesh_terms: D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D010280:Parathyroid Glands / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology*; D012039:Regional Blood Flow; D018615:Ultrasonography, Doppler, Color