PREOPERATIVE LOCALIZATION OF PARATHYROID ADENOMAS - VALUE OF CERVICAL ULTRASONOGRAPHY

Objectives : We evaluated the sensitivity and specificity of cervical ultrasonography for the detection of primary parathyroid adenomas. Methods : From January 1990 to May 1992, ultrasonography was performed before exploratory cervicotomy in 30 patients (10 males, 20 females, mean age 56.3 yr) whose diagnosis was primary hyperparathyroidism based on radioimmunoassay of parathyroid hormone. The same trained operator performed all the ultrasonographic examinations. Results : Twenty-six parathyroid tumours were detected in 23 of the 30 patients examined by ultrasonography. The four standard localizations and one ectopic tumour were visualied. At surgery 37 tumeurs were found in 30 patients. Among the 11 false negatives, the operator had identified an abnormal tumour incorrectly as a cervical lymph node in 2. Most of the false negatives occurred early in the study. The sensitivity of ultrasonography was thus 70 % with a 100 % specificity. Conclusions: Cervical ultrasonography is a reliable, non-invasive and relatively inexpensive examination which should be used as a first-line test for the aetiological assessment of hyperparathyroidism.