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Bridget A. Boudreaux, MD; J. Scott Magnuson, MD; Scott A. Asher, BS; Renee Desmond, DVM, PhD; Glenn E. Peters, MD

Arch Otolaryngol Head Neck Surg. 2007;133(12):1240-1244.

Objective  To assess the role of high-resolution ultrasonography in the preoperative evaluation of patients with hyperparathyroidism.

Design  Retrospective cohort.

Setting  Tertiary care university hospital.

Patients  Three hundred seventeen patients with hyperparathyroidism who underwent preoperative assessment with ultrasonography and/or sestamibi scan and surgical treatment between October 2003 and October 2006.

Main Outcome Measures  Descriptive statistics of localization imaging studies and detection of concomitant thyroid disease in patients presenting with hyperparathyroidism.

Results  Ultrasonography correctly localized the parathyroid adenoma(s) in 148 (69.4%) of the 229 patients with these lesions. Sestamibi scans correctly localized the parathyroid adenoma(s) in 133 (58.1%) of the 229 patients. The agreement between the 2 imaging procedures was moderate ( = 0.23; 95% confidence interval, 0.12-0.36). Of 317 patients with hyperparathyroidism, 96 (30.3%) had clinically significant concomitant thyroid disease requiring partial or total thyroidectomy. Histopathologic examination revealed benign thyroid disease in 80 (83.0%) of the 96 patients and thyroid carcinoma in 16 (16.6%).

Conclusion  Ultrasonography is a useful tool in the preoperative evaluation of patients with hyperparathyroidism both for localization of parathyroid adenomas and for the diagnosis of concomitant thyroid disease.

Author Affiliations: Department of Surgery, Division of Otolaryngology–Head and Neck Surgery (Drs Boudreaux, Magnuson, and Peters), University of Alabama School of Medicine (Mr Asher), and Comprehensive Cancer Center, Division of Biostatistics and Bioinformatics (Dr Desmond), University of Alabama at Birmingham.