Endocrine Abstracts

Introduction

The diagnosis of primary hyperparathyroidism (PHP) is essentially biological. Current imaging techniques (ultrasound and scintigraphy) make it possible to locate an adenoma in the majority of cases. The objective of this study is to clarify the place of imaging in the topographic diagnosis of hyperparathyroidism.

Patients and methods

This is a retrospective study including 40 patients with PHP who have undergone cervical ultrasound and parathyroid scintigraphy, CT scan and MRI are performed as a second line when the latter are negative.

Results

40 patients are identified with a sex ratio of 4/1, the average age was 51 years (range from 18 to 70 years). HPP has been confirmed biologically in all patients. Cervical ultrasound revealed a single adenoma in 30 patients and hyperplasia in 2 cases. Parathyroid scintigraphy was performed in 37 patients, it demonstrated an adenoma in 59.5% of cases. The CT and MRI were negative.

Discussion

Imaging for parathyroid localization should be performed only after the diagnosis of PHP has been confirmed and the decision has been made to proceed with surgery. Localization is not to be used for diagnosis and should not be used to decide if a patient should proceed with surgery.

Conclusion

Through this study, cervical ultrasound appears to be more sensitive than parathyroid scintigraphy in the topographic diagnosis of PHP. Additional CT or MRI is indicated in the event of discordance or ectopic locations.