[Ultrasonic diagnosis in the study of primary hyperparathyroidism]

Ultrasonography (US) of parathyroid glands was performed in 56 patients with clinic and/or laboratory findings diagnostic or strongly suggesting a primary hyperparathyroidism. In 42 cases CT and in 8 US-guided fine needle biopsy (FNB) were performed. Surgical or autoptic confirmation was obtained in 34 patients. In controlled cases US yielded an overall sensibility of 88.46%, specificity of 95.14% and accuracy of 94.58% in identifying enlarged parathyroid glands. Doubtful US findings can be due to atypical pattern or site and associated thyroid pathology: in these cases, also in our experience, US-guided FNB can be usefully employed. US was more accurate than CT in detecting small size glands. In our opinion CT is mandatory only in negative US and/or scintigraphic cases. According to some clinical and surgical problems US may have a localizing or diagnostic role.