ABSTRACT
Objective: To investigate the ultrasonographic features of hyperplastic parathyroid glands in patients with secondary hyperparathyroidism. Methods: Fifty-nine uremic patients accompanied with hyperparathyroidism underwent high resolution parathyroid ultrasonography. On 3 of them ultrasound-guided parathyroid biopsies were performed. The ultrasonographic manifestations of the hyperplastic parathyroids were compared with the optical histology from biopsy. Results :(1) The overall detection rate of parathyroid glands was 83.1% by high resolution ultrasonography, and among those 93. 9% were found to have 1 to 2 glands detectable. (2) Five kinds of manifestations were found, among which the homogeneous internal hypoechoes and multiple hyperechoic rings of calcification in the parathyroid parenchyma were characteristic. (3) One patient showed coexistence of adenoma hyperechoes and hyperplasia hypoechoes in a single parathyroid gland. (4) Lithonephria occured in the transplanted kidney in a patient received renal treated by a successful transplantation, which was indicative of tertiary hyperparathyroidism. Conclusion: High resolution ultrasonography is sensitive and specific to detect the abnormalities of parathyroid glands in the patients with secondary hyperparathyroidism. It is complementary to the laboratory tests of serum parathyroid hormone and serum calcium, and it is valuable for the diagnosis and followup evaluation of hyperparathyroidism. It may be used for the screening of presence or future development of secondary hyperparathyroidism in uremic candidates.