Parathyroid imaging: comparison of high-resolution CT and high-resolution sonography.

Parathyroid computed tomographic (CT) scanning using a specially designed patient positioning harness, bolus contrast administration, and dynamic scanning significantly improved localization of parathyroid tumors from 45% (19/42) to 76% (35/46) (p less than 0.01) over conventional CT scanning. High-resolution sonography with a 10 MHz transducer localized 65% (57/88) of these tumors. Average tumor size was 15 X 10 X 9 mm. Patients undergoing reoperation for hyperparathyroidism had similarly small tumors localized by CT in 63% (12/19) and high-resolution sonography in 47% (9/19) of cases. High-resolution sonographic equipment suitable for parathyroid imaging is not widely available. Since high-resolution CT is more generally available and more effective, it is recommended as the procedure of choice for localizing cervical parathyroid tumors.