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© 2002 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 21:539-552 • 0278-4297

Sonography in Primary Hyperparathyroidism

Review With Emphasis on Scanning Technique

Scott B. Reeder, MD, PhD, Terry S. Desser, MD, Ronald J. Weigel, MD, PhD and R. Brooke Jeffrey, MD

Departments of Radiology (S.B.R., T.S.D., R.B.J.) and Surgery (R.J.W.), Stanford University Medical Center, Stanford California; and Department of Radiology, VA Palo Alto Health Care System, Palo Alto, California (T.S.D.).

Address correspondence and reprint requests to R. Brooke Jeffrey, MD, Stanford University Medical Center, 300 Pasteur Ave, Room H1306, Stanford, CA 94304.

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 (>=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.

Key Words: parathyroid adenoma • sonography • localization • color Doppler sonography

Abbreviations: PTH, parathyroid hormone • Tc99m, technetium Tc 99m




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Copyright © 2002 by the American Institute of Ultrasound in Medicine.