Stratégie d'imagerie chez un patient suspect d'hyperparathyroïdie primaire

Primary hyperparathyroidism is a rare condition. Surgery is mandatory. Imaging strategy remains controversial. In some centers, neck surgical exploration is performed in patients with biologically proven hyperparathyroidism. Imaging is done only if surgery has failed, in order to detect ectopic glands. In other institutions, preoperative imaging is systematic and somewhat more extensive. Association of ultrasonography and scintigraphy is the best initial strategy. In case of discrepancy, CT and/or MRI enable identification of ectopic tissue. Knowledge of embryological variants is useful to help in the choice and interpretation of the best adapted imaging modality in a given patient.