Abstract
With the ever-increasing use of minimally invasive parathyroidectomy over bilateral neck exploration for patients with primary hyperparathyroidism, precise and accurate detection and preoperative localisation of parathyroid adenomas are very important to enable successful surgical outcome and better patient management. With the absence of evidence-based guidelines on optimal imaging strategy, clinicians are left with the choice of techniques that are available in their clinical practice. In this research, the efficacy of ultrasound in detection and preoperative localisation of parathyroid adenomas were reviewed. The advantages and disadvantages of ultrasound were also discussed.
Methodology: A quantitative, correlational design method was used. Data of 102 patients seen at the Endocrine department and referred for neck ultrasound examination to the Radiology department between 2013 and 2022, was extracted. All the patients underwent parathyroidectomy. The preoperative localisation of parathyroids by ultrasound was compared with the surgery and histology reports. The study was performed at a single setting at one of the public hospitals in Soweto, Johannesburg. The study collected non-randomised nominal data mandating the use of non-parametric statistical tests.
Results: Study participants comprised females (73%), people of Black ethnicity (83.3%) and the elderly, defined as people aged 65 and older (35.3%) with a mean age of 60 years. The ultrasound sensitivity and specificity were found to be 97.1% and 95.1% respectively.
Conclusion: In our setting, preoperative detection and localisation of parathyroid adenomas by ultrasound, performed by an experienced sonographer with expertise in neck imaging, had a high diagnostic yield.