High-resolution parathyroid sonography.

A total of 165 consecutive patients with suspected primary hyperparthyroidism was scanned preoperatively using high-resolution real-time sonography. The sensitivity of the procedure was 69% and the specificity 94% in the localization of individually enlarged parathyroid glands. In the subgroup of 21 patients undergoing reoperation in the neck, the sensitivity and specificity were 80% and 92%, respectively. In patients with a single parathyroid adenoma, there was a close but not linear correlation between sonographic diagnostic accuracy and the size of the adenoma, which in turn was directly related to the serum calcium and immunoreactive parathyroid hormone levels. High-resolution sonography has become the procedure of choice in our institution for the preoperative localization of enlarged parathyroid glands in the neck.