Abstract: Objective To investigate the clinical value of high-frequency color Doppler ultrasonography in secondary hyperparathyroidism following chronic renal failure. Methods Ultrasonographic characteristics of hyperplastic parathyroid nodules confirmed by pathology after surgery were retrospectively analyzed in 36 patients. Results A total of 134 clinically diagnosed hyperplastic parathyroid nodules were surgically removed from 36 patients. In these surgical samples, pathological examination confirmed to be hyperplastic parathyroid nodules in 120 samples, and non-parathyroid hyperplasia (including thyroid nodules and ectopic thymus) in 14 samples. In the 120 samples of hyperplastic parathyroid nodules, ectopic parathyroid located in thymus in 3 samples and in thyroid in one sample. Hyperplastic parathyroid nodules complicated with thyroid carcinoma was found in 3 cases (3/36, 8.3%). Ultrasonography detected 84 nodules of parathyroid enlargement or hyperplasia (maximal size of 2.6 cm x 1.6 cm x 1.5 cm and minimal size of 0.30 cm x 0.27 cm x 0.21 cm), in which 81 samples (96.4%) had the same diagnosis by pathological examination, with the rate of correct diagnosis of 67.5% (81/120), and the rate of missed nodules of 32.5% (39/120). Misdiagnosed nodules by ultrasonography occurred in 3 samples including lymph node in the lower pole of thyroid in one sample and thyroid nodule in 2 samples, with the rate of misdiagnosis of 3.6% (3/84). Conclusion High-frequency color Doppler ultrasonography can be used as the preferred screening method for the diagnosis and localization of parathyroid hyperplasia before surgery, and for the diagnosis of secondary hyperparathyroidism complicated with thyroid carcinoma.

Key words: Secondary hyperparathyroidism, Parathyroid, Color Doppler ultrasonography, Ultrasonic diagnosis