The role of colour Doppler ultrasonography in the preoperative localization of parathyroid adenomas

The aim of the present study was to evaluate the diagnostic accuracy and imaging patterns of colour Doppler ultrasonography (US) and compare it with grayscale US, 99m-Tc methoxyisobutylisonitrile (MIBI) scans, and combined US and MIBI scans in the preoperative diagnosis of parathyroid adenomas in patients with primary hyperparathyroidism (pHPT). From June 2007 to June 2011, 36 consecutive patients (seven men and 29 women) with pHPT underwent grayscale US, colour Doppler ultrasonography (CDUS), and 99m-Tc MIBI scans prior to parathyroidectomy with traditional unilateral neck dissection. All 36 patients with pHPT underwent parathyroidectomy at our university hospital. According to histopathology results, the sensitivity, specificity, and accuracy of MIBI and US scan were 88%, 94%, and 91%, and 70%, 100%, and 85%, respectively. The overall sensitivity and specificity of combined US and MIBI was 97% and 100% respectively. The overall sensitivity, specificity, and accuracy of CDUS in the correct diagnosis of parathyroid adenoma were 97%, 100%, and 98.6%, respectively. The sensitivity and specificity of US in the detection of parathyroid adenoma and differentiating it from other cervical masses reached up to 97% and 100%, respectively, by combining CDUS with grayscale evaluations of parathyroid adenoma.