Use of color Doppler imaging in the distinction between thyroid and parathyroid lesions

To determine whether the use of color Doppler imaging in conjunction with standard high-resolution 10-MHz ultrasound could increase the screening sensitivity in distinguishing between thyroid and parathyroid lesions in the detection of parathyroid disease, we studied 32 patients with hyperparathyroidism with both modalities who were subsequently treated surgically. Among these 32 patients, parathyroid lesions were predominantly avascular (n = 21, average size 0.9 x 0.6 cm) but with increased size demonstrated some vascularity (n = 9, average size 2.1 x 1 cm, 32%). Of these 32 patients, 46.6% had thyroid lesions as well. Thyroid lesions were avascular when small (n = 26 lesions, average size 0.5 x 0.5 cm) but tended to demonstrate vascularity (n = 14, 35%) at about 1 cm in size or greater. Although the addition of color Doppler imaging enabled the differentiation of vessel from soft-tissue abnormalities and some distinction between parathyroid and thyroid lesions, it had no effect on overall sensitivity (65%) in the detection of parathyroid disease.