[Diagnostic imaging in primary hyperparathyroidism. Radiological techniques: US--CAT--MR]

This study aims to clarify the diagnostic value of ultrasonography, computerised tomography and magnetic resonance in adenomatous pathology of primary and persistent hyperparathyroidism. Although the diagnostic efficacy of the various imaging techniques is still the subject of current debate, the latest specific surgical techniques, require their use either individually or in association, in order to achieve faster and safer surgery. After an overview of the various methods, illustrating their indications and diagnostic limitations, the authors emphasise that the role played by ultrasonography, CAT and MR justifies their use in the preoperative localisation of parathyroid adenoma. It is not possible to assert in absolute terms that one methods is better than another, but each offers different potential. The use of US as the method of choice is indicated in primary hyperparathyroidism with hyperplastic glands owing to its innocuous nature and rapidity. In addition to US and scintigraphy, magnetic resonance may be appropriate in primary hyperparathyroidism with adenomatous glands. In persistent forms of primary hyperparathyroidism, magnetic resonance is the most reliable method, whereas CT and, to an even greater degree, ultrasonography play a marginal role.