Objective: To assess the accuracy of preoperative imaging studies in primary hyperparathyroidism.
Design: Retrospective review of all patients treated surgically for primary hyperparathyroidism at The University of California-San Diego Medical Center between January 1990 and May 1992. Results of preoperative imaging studies were compared with surgical and pathologic findings.
Setting: The University of California-San Diego Medical Center, a primary care and referral center.
Participants: Twenty-eight patients were included in the study, and a total of 41 imaging studies were obtained.
Outcome measures: The accuracy of preoperative imaging studies in correctly localizing the site of a parathyroid adenoma.
Results: Ultrasound correctly identified the site of a solitary parathyroid adenoma in 82% of cases, and magnetic resonance imaging in 80% of cases. The adenomas that were not localized by ultrasound were correctly localized by magnetic resonance imaging. These findings are discussed within the context of recent trends in parathyroid surgery.
Conclusions: Based on the results and a review of the literature, a simple algorithm for the use of these imaging studies is proposed. Use of this algorithm will improve preoperative planning, and potentially reduce operative time and morbidity.