Possibility of 2-D and Color Doppler sonography in distinguishing diffuse and nodular parathyroid hyperplasia

Based on recent knowledge of the pathogenesis of chronic renal failure and histopathology of the parathyroid gland (PTG) in secondary hyperparathyroidism (SHPT), we know that hyperplastic PTG has two forms: diffuse and nodular. The aim of this study is to prove the usefulness of sonography for detection of PTG increase in size in SHPT and the possibility of differentiation between diffuse and nodular hyperplasia. 2-D high resolution sonography with a 10 MHz probe and Color Doppler was performed. 362 enlarged PTG in 120 uremic patients were analyzed. In sonographic findings, uniform echoes representing diffuse hyperplasia, were found in 48% of enlarged PTG, while others had internal changes. Color Doppler improved differentiation between diffuse and nodular changes. PTG with nodular pattern were bigger than those with homogeneous echoes. Patients with nodular pattern had a PTH level more elevated than patients with uniform echoes. The difference was significant (p