PREOPERATIVE LOCALIZATION OF PARATHYROID ADENOMAS - VALUE OF CERVICALULTRASONOGRAPHY

Objectives : We evaluated the sensitivity and specificity of cervical ultrasonography for the detection of primary parathyroid adenomas. Met hods : From January 1990 to May 1992, ultrasonography was performed be fore exploratory cervicotomy in 30 patients (10 males, 20 females, mea n age 56.3 yr) whose diagnosis was primary hyperparathyroidism based o n radioimmunoassay of parathyroid hormone. The same trained operator p erformed all the ultrasonographic examinations. Results : Twenty-six p arathyroid tumours were detected in 23 of the 30 patients examined by ultrasonography. The four standard localizations and one ectopic tumou r were visualied. At surgery 37 tumeurs were found in 30 patients. Amo ng the 11 false negatives, the operator had identified an abnormal tum our incorrectly as a cervical lymph node in 2. Most of the false negat ives occurred early in the study. The sensitivity of ultrasonography w as thus 70 % with a 100 % specificity. Conclusions: Cervical ultrasono graphy is a reliable, non-invasive and relatively inexpensive examinat ion which should be used as a first-line test for the aetiological ass essment of hyperparathyroidism.