Parathyroid aspiration biopsy under ultrasound guidance in the postoperative hyperparathyroid patient

A 10-MHz high-resolution dedicated small parts scanner and a static 5-MHz digital scanner were used in the ultrasound (US) examination of 11 patients with hyperparathyroidism who had previously undergone surgery of the parathyroid (eight patients) or thyroid (three patients) gland. Using US localization, aspiration biopsies were performed successfully in nine patients: parathyroid disease was confirmed in seven patients and thyroid lesions in two. Inadequate aspirate was obtained in one patient; in another patient a biopsy was done successfully under CT guidance following a negative US examination. The authors conclude that high-resolution US is an effective tool for guiding the aspiration biopsy of nonpalpable parathyroid tumors in patients who have had neck surgery. They suggest modifications of the US equipment that would simplify the localization procedure.