USEFULNESS OF ECHO-COLOR DOPPLER IN DIFFERENTIATING PARATHYROID LESIONS FROM OTHER CERVICAL MASSES

The aim of our study was to clarify possible differential color Dopple r US features between parathyroid lesions and other cervical masses. A total of 56 parathyroid lesions in 54 patients with primary hyperpara thyroidism were preoperatively examined with color Doppler sonography. Color Doppler flow patterns were compared with those of 72 thyroid no dules and 20 cervical lymph nodes. In 38 parathyroid lesions a correla tion between color Doppler patterns and size, location, and pathologic al findings was performed. Color Doppler sonography showed five vascul ar distribution patterns: pattern I, absence of flow, pattern II, foca l peripheral flow (''vascular pole'') with arterial Doppler spectrum; pattern III, peripheral flow; pattern IV, internal flour (''parenchyma l pattern''); pattern V, peripheral and intranodular flow. Pattern I w as not specific for any cervical lesion considered. Conversely, patter n TV was observed solely in parathyroid lesions, and pattern II was ob served in only one nonparathyroid lesion (thyroid nodule). Mixed patte rn (pattern V) was observed solely in thyroid nodules. In addition, pa ttern III was a characteristic finding of thyroid nodules and was obse rved in only one parathyroid lesion. Color Doppler patterns of the par athyroid masses did not correlate with the size of the lesion or patho logical findings, but only with the location of the gland. Our study s howed that color Doppler assessment of parathyroid lesions is a useful integration of gray-scale US and may be helpful in distinguishing par athyroid lesions from other cervical masses.