Apart from computed tomography, sonography is the most valuable clinical method for the pre-operative diagnosis of parathyroid tumours. Eighty-six patients were examined by high resolution ultrasound (7.5 and 10 MHz) and in 63 of these the sonographic findings could be compared with the results of surgery. Sensitivity of 67.5% was highest amongst 40 patients with primary hyperparathyroidism. Patients who had had previous operations on the neck showed a slightly lower sensitivity of 65%. In secondary and tertiary hyperparathyroidism, sensitivity was 54%. The main causes of error were small size of the adenoma, changes in the thyroid gland and previous surgery to the neck. The value of sonography for diagnosis and surgical planning is discussed.
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