title: Variable sonographic spectrum of parathyroid adenoma with a novel ultrasound finding: dual concentric echo sign.
abstract: OBJECTIVE
  To review the detailed gray-scale and Doppler ultrasonography features of histologically proven parathyroid adenomas (PAs) evaluated with high-end ultrasonography devices and to present a novel ultrasonography finding called the dual concentric echo sign in PA with histopathologic correlation which was encountered during detailed analysis.
  
  
  METHODS
  Fifty-six PAs with histopathological result were enrolled. The longest dimension, shape, distance to skin surface, internal echo and Doppler US features obtained with high-end US devices were evaluated.
  
  
  RESULTS
  PAs had variable range of shape including oval, irregular, fusiform, lobulated, crescent-shaped, and nodular configuration. In nine patients the lesions were shown to have cystic components and calcifications were seen in four cases. Dual concentric echo sign was detected in 18% PAs. Histological reevaluation of this subgroup demonstrated significantly increased edema (p<0.01), and ectatic vessels (p=0.02) in the central part of the lesion compared to the rest of the PAs.
  
  
  CONCLUSIONS
  The results of the study led to the conclusion that PAs have variable gray-scale and Doppler findings. Typical sonographic features like ovoid shape, homogeneously hypoechoic pattern may not be present in all PAs. Dual concentric echo sign which is a novel sonographic pattern may be suggestive of a PA.
authors.affiliation: Department of Radiology, Mevlana University School of Medicine, Konya, Turkey. drtacar@hotmail.com.
authors.forename: Turker
authors.initials: T
authors.lastname: Acar
authors.affiliation: Department of Radiology, Ege University School of Medicine, Izmir, Turkey.
authors.forename: Suha Sureyya
authors.initials: SS
authors.lastname: Ozbek
authors.affiliation: Department of Pathology, Ege University School of Medicine, Izmir, Turkey.
authors.forename: Yesim
authors.initials: Y
authors.lastname: Ertan
authors.affiliation: Department of Radiology, Ege University School of Medicine, Izmir, Turkey.
authors.forename: Gulgun
authors.initials: G
authors.lastname: Kavukcu
authors.affiliation: Department of Pathology, Ege University School of Medicine, Izmir, Turkey.
authors.forename: Muge
authors.initials: M
authors.lastname: Tuncyurek
authors.affiliation: Department of Surgery, Ege University School of Medicine, Izmir, Turkey.
authors.forename: Recep Gokhan
authors.initials: RG
authors.lastname: Icoz
authors.affiliation: Department of Surgery, Ege University School of Medicine, Izmir, Turkey.
authors.forename: Mehmet Mahir
authors.initials: MM
authors.lastname: Akyildiz
authors.affiliation: Department of Surgery, Ege University School of Medicine, Izmir, Turkey.
authors.forename: Ozer
authors.initials: O
authors.lastname: Makay
authors.affiliation: Department of Family Medicine, Tepecik Education and Training Hospital, Izmir, Turkey.
authors.forename: Seval
authors.initials: S
authors.lastname: Acar
mesh_terms: D000236:Adenoma / Q000000981:diagnostic imaging*; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010282:Parathyroid Neoplasms / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D018615:Ultrasonography, Doppler, Color