Pre-operative localization of parathyroid tumor by ultrasonography

From July 1984 to June 1989, 24 cases with hypercalcemia and surgical proof of parathyroid adenoma or carcinoma received preoperative parathyroid sonographic examination in Chang Gung Memorial Hospital. There were 10 male patients with mean age of 51.5 +/- 12.3, and 14 female patients with mean age of 49.4 +/- 12.6. Parathyroid enlargement was detected by sonography examination in 22 of the 24 cases. The maximal diameter of the enlarged parathyroid in this series ranged from 1 cm to 3 cm. The accuracy of case diagnosis with sonography is 83.3%. In 96 parathyroid glands examined by sonography, the sensitivity is 83.3%, the specificity is 95.8% and the positive predictive value is 87%. From the results, it suggests that parathyroid sonography can be used as the first line localization method to detect parathyroid enlargement in hypercalcemia patients.