Evaluation of the microvascularization of pathologic parathyroid glands in patients with primary hyperparathyroidism using conventional ultrasound and contrast-enhanced ultrasound.

PURPOSE: The objective was to characterize the microcirculation of parathyroid adenomas using contrast-enhanced ultrasound (CEUS) and to evaluate if it can be used for diagnosis and localization of pathologic glands.

PATIENTS AND

METHODS

Thirty patients with primary hyperparathyroidism scheduled for parathyroidectomy were enrolled. Preoperatively, all patients underwent B-Scan sonography, Colour coded Doppler Sonography (CCDS), Power Doppler (PD) and CEUS. The diagnostic confidence concerning B-Scan, CCDS, PD and CEUS was classified into six grades (0: no adenoma; 5: adenoma).

RESULTS

Using CEUS, all adenomatous glands showed a typical dynamic microvascularization. B-Scan showed a mean grade of 2.18, CCDS 2.29, PD 2.33, CEUS 4.29 (6-9 MHz transducer) and 3.52 (6-15 MHz). The differences between CEUS and conventional sonography were all statistically significant (p < 0.05). CEUS noted a sensitivity of 98.4% and specificity of 98.4% for the detection of adenomatous glands.

CONCLUSION

CEUS facilitates the detection and diagnosis of pathologic parathyroid glands due to their typical microvascularization.