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  • Title: Sonography in primary hyperparathyroidism: review with emphasis on scanning technique.
    Author: Reeder SB, Desser TS, Weigel RJ, Jeffrey RB.
    Journal: J Ultrasound Med; 2002 May; 21(5):539-52; quiz 553-4. PubMed ID: 12008817.
    Abstract:
    OBJECTIVE: To review the sonographic features and focused sonographic scanning techniques that may assist in the preoperative localization of parathyroid adenomas in patients with primary hyperparathyroidism. METHODS: The sonographic findings were reviewed in 54 of 58 consecutive patients with pathologically proven parathyroid adenomas. A systematic scanning approach including real-time gray scale, color and power Doppler, and graded compression gray scale imaging was used in all patients. RESULTS: Fifty-four (93%) of 58 proven adenomas were correctly identified by sonography. Gray scale imaging alone was sufficient for identifying 26 (100%) of 26 large (> or =1-cm) and 3 (11%) of 25 small (<1-cm) parathyroid adenomas. However, for 25 (89%) of 28 small adenomas, a combination of color and power Doppler and graded compression real-time gray scale imaging was required for sonographic localization and identification. CONCLUSIONS: Knowledge of typical locations and characteristic imaging features, as well as a systematic scanning approach, can result in accurate preoperative sonographic localization of parathyroid adenomas.
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