Parathyroid Ultrasound

  • Robert A. SoffermanEmail author


Before delving into a comprehensive discussion of parathyroid ultrasound, the embryology, anatomy, and particularly vascular supply of the parathyroid glands are relevant and important to review. This information will permit the sonographer/clinician to differentiate lymphadenopathy and thyroid pathology from true parathyroid lesions. As with any imaging study, the history and laboratory data will influence the expectations of the pathobiology and often whether one or more glands are enlarged. As an example, patients with renal failure or those with MEN syndromes are likely to demonstrate multiple-gland enlargement. The patient with extreme elevation in calcium and parathyroid hormone levels may be suspect for parathyroid carcinoma. The importance of linking clinical information to the concepts of parathyroid ultrasound cannot be overemphasized.


Parathyroid Gland Recurrent Laryngeal Nerve Primary Hyperparathyroidism Parathyroid Adenoma Parathyroid Carcinoma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

47-Inferior parathyroid adenoma, transverse view (3,381 KB)

48-Paraathyroid adenoma, inferrior, trans and sagittal views (3,114 KB)

49-Superior parathyroid adenoma, sagittal image (78,524 KB)

50-Superior parathyroid adenoma, transverse image (2) (51,460 KB)

51-Superior parathyroid adenoma, sagittal image (2) (51,905 KB)

52-Small parathyroid adenoma, transverse image, Color Dopple (21,109 KB)

53-Small parathyroid adenoma, sagittal image, Color Doppler (21,399 KB)

54-Small inferior parathyroid adenoma with appropriate penet (30,691 KB)

55-Small inferior parathyroid adenoma with parathyroid arter (30,213 KB)

56-Parathyroid adeoma thymus, transverse image, Color Dopple (1,261 KB)

57-Excellent demonstration of blunt ending of parathyroid ar (1,631 KB)

58-Parathyroid adenoma, Color Doppler, demonstrating single (14,292 KB)

59-Parathyroid adenoma, sagittal image, Color Doppler, demon (19,200 KB)

60-Large parathyroid adenoma with demonstration of dominant (2,256 KB)

61-Cystic intrathyroidal parathyroid adenoma, composite tran (2,037 KB)

62-Parathyroid hyperplasia in MEN I demonstrating 2 enlarged (73,959 KB)

63-Intrathyroidal parathyroid adenoma, sagittal image. Supe (57,644 KB)

64-Intrathyroidal parathyroid adenoma, Color Doppler, demons (21,477 KB)

65-Ectopic parathyroid adenoma lateral neck, cine doppler (21,534 KB)


  1. 1.
    Abboud B et al. Intrathyroid parathyroid adenoma in primary hyperparathyroidism: can it be predicted preoperatively? World J Surg. 2007;31:817–23.PubMedCrossRefGoogle Scholar
  2. 2.
    Gilmour JR. The gross anatomy of the parathyroid glands. J Pathol. 1938;46:133.CrossRefGoogle Scholar
  3. 3.
    Andre V, Andre M, LeDreff P, Granier H, Forlodou P, Garcia JF. Intrathyroidal parathyroid adenoma. J Radiol. 1999;80:591–2.PubMedGoogle Scholar
  4. 4.
    McIntyre Jr R, Eisenach J, Pearlman N, Ridgeway C, Liechty RD. Intrathyroidal parathyroid glands can be a cause of failed cervical exploration for hyperparathyroidism. Am J Surg. 1997;174:750–4.PubMedCrossRefGoogle Scholar
  5. 5.
    Flament JB, Delattre JF, Pluot M. Arterial supply to the parathyroid glands: implications for thyroid surgery. Anat Clin. 1982;3:279.CrossRefGoogle Scholar
  6. 6.
    Abboud B et al. Ultrasonography: highly accuracy technique for preoperative localization of parathyroid adenoma. Laryngoscope. 2008;118:1574–8.PubMedCrossRefGoogle Scholar
  7. 7.
    Baskin J, Duick D, Levine R. Thyroid ultrasound and ultrasound guided FNA. 2nd ed. New York: Springer; 2008. p. 139.CrossRefGoogle Scholar
  8. 8.
    Randel SB, Gooding GA, Clark OH, et al. Parathyroid variants: US evaluation. Radiology. 1987;165:191–4.PubMedGoogle Scholar
  9. 9.
    Mazzeo S et al. Usefulness of echo color Doppler in differentiating parathyroid lesions from other cervical masses. Eur Radiol. 1997;7:90–5.PubMedCrossRefGoogle Scholar
  10. 10.
    Lane MJ, Desser TS, Weigel RJ, Jeffrey Jr RB. Use of color and power Doppler sonography to identify feeding arteries associated with parathyroid adenomas. Am J Roentgenol. 1998;171:818–23.Google Scholar
  11. 11.
    Reeder SB, Desser TS, Weigel RJ, Jeffrey RB. Sonography in primary hyperparathyroidism: review with emphasis on scanning technique. J Ultrasound Med. 2002;21:539–52.PubMedGoogle Scholar
  12. 12.
    Lane MJ et al. Use of color and power Doppler sonography to identify feeding arteries associated with parathyroid adenomas. Am J Roentgenol. 1998;171:819–23.Google Scholar
  13. 13.
    Marcocci C et al. Preoperative localization of suspicious adenomas by assay of parathyroid hormone in needle aspirates. Eur J Endocrinol. 1998;139:72–7.PubMedCrossRefGoogle Scholar
  14. 14.
    Marcocci C et al. Preoperative localization of suspicious parathyroid adenoma by assay of parathyroid hormone in needle aspirates. Eur J Endocrinol. 1999;139:72–7.CrossRefGoogle Scholar
  15. 15.
    Gwande A et al. Reassessment of parathyroid hormone monitoring during parathyroidectomy for primary hyperparathyroidism after two preoperative localization studies. Arch Surg. 2006;141:381–4.CrossRefGoogle Scholar
  16. 16.
    Adler JT, Chen H, Schaefer S, Sippel RS. Does routine use of ultrasound result in additional thyroid procedures in patients with primary hyperparathyroidism? J Am Coll Surg. 2010;221:536–9.CrossRefGoogle Scholar
  17. 17.
    Ghaheri BA, Koslin DB, Wood AH, Cohen JI. Preoperative ultrasound is worthwhile for reoperative parathyroid surgery. Laryngoscope. 2004;114:2168–71.PubMedCrossRefGoogle Scholar
  18. 18.
    Ihm P, Dray T, Sofferman R, Nathan M, Hardin N. Parathyroid cyst: diagnosis and management. Laryngocope. 2006;111:1406–9.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Division of Otolaryngology-Head and Neck SurgeryUniversity of Vermont School of Medicine, Fletcher Allen Health CareBurlingtonUSA

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