We aimed to evaluate the role of neck ultrasonography alone for preoperative localization of parathyroid adenoma due to primary hyperparathyroidism.

We analyzed 117 patients (87 female and 30 male patients, mean age: 53.8 years) who had parathyroidectomy due to primary hyperparathyroidism and had only preoperative neck ultrasonography (USG) as the localisation study. The preoperative radiological findings were correlated with operative and pathological results.

124 parathyroidectomies were done in 117 patients who had preoperative neck USG alone as imaging done by a single radiologist experienced in the field of head and neck ultrasonography. 6 patients had parathyroid gland in carotid sheath and the rest had parathyroid glands in cervical region. With USG, in 3 patients, localisation side was right but upper or lower region was identified incorrectly. In 3 cases, parathyroid hormone (PTH) and calcium levels were high postoperatively. In 2 of these 3 cases, parathyroid glands were hyperplastic and in 1, no parathyroid gland was found. 4 double adenomas were found and in all 4 cases one gland was hyperplastic and the other parathyroid gland was normal. In these 4 cases, only in 1 patient, PTH and calcium did not decline to normal levels postoperatively. The sensitivitiy, specifity, positive predictive value and negative predictive value were 97.4%, 80%, 93.3%, 60% for neck ultrasonography respectively.

Neck ultrasonography alone by an experienced radiologist is effective in localisation of parathyroid adenomas in primary hyperparathyroidism.