[Current complex noninvasive diagnosis of parathyroid tumors]

The diagnosis of bulky formations of the parathyroid glands (PTG) has become possible since current high-resolution techniques of visualization, such as ultrasound study (USS), computed tomography (CT), magnetic resonance imaging (MRI), were introduced into practice. The presence of clinical and/or laboratory signs of hyperparathyroidism (HPT) is a signal to initiate a goal-oriented search for abnormal PTG formations. The complex diagnosis of HPT involves the methods of detecting osteoporosis ranging from routine X-ray study of the hand and foot to more in-depth techniques: dichromatic X-ray absorptiometry (DXA) and quantitative CT (QCT). USS is an excellent method for screening if abnormal PTC changes are suspected; however, negative USS results in the presence of clinical and/or laboratory signs of HPT should not stop a diagnostic search. CT with intravenous contrast bolus specifies the site and structure of an formation, has some advantage in detecting retrosternal tumors. Due to its high tissue contrast, three-dimensional images, none ionizing radiation and osseous structural artefacts, MRI becomes a preferable tool for studying PTG when they are typically or atypically located. Needle biopsy is required when noninvasive methods cannot characterize the pattern of an abnormal PTG formation properly or their results are contradictory.