Ultrasound detection of normal parathyroid glands: detection rate, topographic anatomy, and the role of underlying thyroid disease

IntroductionVisualizing normal parathyroid glands (PTGs) using ultrasound (US) has historically been challenging. This study aims to assess the detection rate of normal PTGs in thyroid patients and evaluate their echostructure, anatomical location and their relation with the underlying thyroid patho...

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Main Authors: Isabella Chiardi, Petra Makovac, Andrea Leoncini, Flavio Forte, Mario Rotondi, Pierpaolo Trimboli
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Endocrinology
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Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2025.1595940/full
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author Isabella Chiardi
Isabella Chiardi
Petra Makovac
Andrea Leoncini
Flavio Forte
Mario Rotondi
Mario Rotondi
Pierpaolo Trimboli
Pierpaolo Trimboli
author_facet Isabella Chiardi
Isabella Chiardi
Petra Makovac
Andrea Leoncini
Flavio Forte
Mario Rotondi
Mario Rotondi
Pierpaolo Trimboli
Pierpaolo Trimboli
author_sort Isabella Chiardi
collection DOAJ
description IntroductionVisualizing normal parathyroid glands (PTGs) using ultrasound (US) has historically been challenging. This study aims to assess the detection rate of normal PTGs in thyroid patients and evaluate their echostructure, anatomical location and their relation with the underlying thyroid pathology.MethodsA retrospective observational study was conducted over four weeks (September–October 2024) at the Thyroid Unit of Ente Ospedaliero Cantonale (EOC). Consecutive thyroid patients undergoing US for any thyroid indication were included, while those with a history of parathyroid disease, chronic kidney disease, or recent thyroid surgery were excluded. The primary outcome was the detection rate of normal PTGs. Secondary outcomes included PTG echostructure, anatomical location, and correlations with patient characteristics (age, gender, BMI, thyroid volume, and underlying thyroid pathology).ResultsNormal PTGs were identified in 45.1% of patients (n=51). Most PTGs were located near the lower pole of the thyroid lobes and appeared mildly hyperechoic. Thyroid volume was inversely associated with PTG detection (p=0.001), while underlying thyroid pathology (e.g., thyroiditis, nodular disease) had no significant impact on detection rates.ConclusionNormal PTGs can be visualized using US, particularly near the lower thyroid poles. Detection rates decrease in patients with larger thyroid volumes or athyreotic status. These findings confirm and expand on recent studies, challenging the historical belief that normal PTGs are undetectable, with potential implications for endocrine imaging and surgical planning.
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spelling doaj-art-aba264c0165b4acdb8cfcd08e15f731d2025-08-20T03:36:10ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-07-011610.3389/fendo.2025.15959401595940Ultrasound detection of normal parathyroid glands: detection rate, topographic anatomy, and the role of underlying thyroid diseaseIsabella Chiardi0Isabella Chiardi1Petra Makovac2Andrea Leoncini3Flavio Forte4Mario Rotondi5Mario Rotondi6Pierpaolo Trimboli7Pierpaolo Trimboli8Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, ItalyThyroid Unit, Clinic for Endocrinology and Diabetology, Ente Ospedaliero Cantonale (EOC), Bellinzona, SwitzerlandService of Surgery, Ospedale Regionale di Mendrisio, Ente Ospedaliero Cantonale (EOC), Mendrisio, SwitzerlandClinic for Radiology, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Bellinzona, SwitzerlandUrologic Division, Vannini Hospital, Rome, ItalyDepartment of Internal Medicine and Therapeutics, University of Pavia, Pavia, ItalyIstituti Clinici Scientifici Maugeri IRCCS, Unit of Endocrinology and Metabolism, Laboratory for Endocrine Disruptors, Pavia, ItalyThyroid Unit, Clinic for Endocrinology and Diabetology, Ente Ospedaliero Cantonale (EOC), Bellinzona, SwitzerlandFaculty of Biomedical Sciences, Università Della Svizzera Italiana (USI), Lugano, SwitzerlandIntroductionVisualizing normal parathyroid glands (PTGs) using ultrasound (US) has historically been challenging. This study aims to assess the detection rate of normal PTGs in thyroid patients and evaluate their echostructure, anatomical location and their relation with the underlying thyroid pathology.MethodsA retrospective observational study was conducted over four weeks (September–October 2024) at the Thyroid Unit of Ente Ospedaliero Cantonale (EOC). Consecutive thyroid patients undergoing US for any thyroid indication were included, while those with a history of parathyroid disease, chronic kidney disease, or recent thyroid surgery were excluded. The primary outcome was the detection rate of normal PTGs. Secondary outcomes included PTG echostructure, anatomical location, and correlations with patient characteristics (age, gender, BMI, thyroid volume, and underlying thyroid pathology).ResultsNormal PTGs were identified in 45.1% of patients (n=51). Most PTGs were located near the lower pole of the thyroid lobes and appeared mildly hyperechoic. Thyroid volume was inversely associated with PTG detection (p=0.001), while underlying thyroid pathology (e.g., thyroiditis, nodular disease) had no significant impact on detection rates.ConclusionNormal PTGs can be visualized using US, particularly near the lower thyroid poles. Detection rates decrease in patients with larger thyroid volumes or athyreotic status. These findings confirm and expand on recent studies, challenging the historical belief that normal PTGs are undetectable, with potential implications for endocrine imaging and surgical planning.https://www.frontiersin.org/articles/10.3389/fendo.2025.1595940/fullUSnormal parathyroidsparathyroid detectionparathyroid imagingneck ultrasound
spellingShingle Isabella Chiardi
Isabella Chiardi
Petra Makovac
Andrea Leoncini
Flavio Forte
Mario Rotondi
Mario Rotondi
Pierpaolo Trimboli
Pierpaolo Trimboli
Ultrasound detection of normal parathyroid glands: detection rate, topographic anatomy, and the role of underlying thyroid disease
Frontiers in Endocrinology
US
normal parathyroids
parathyroid detection
parathyroid imaging
neck ultrasound
title Ultrasound detection of normal parathyroid glands: detection rate, topographic anatomy, and the role of underlying thyroid disease
title_full Ultrasound detection of normal parathyroid glands: detection rate, topographic anatomy, and the role of underlying thyroid disease
title_fullStr Ultrasound detection of normal parathyroid glands: detection rate, topographic anatomy, and the role of underlying thyroid disease
title_full_unstemmed Ultrasound detection of normal parathyroid glands: detection rate, topographic anatomy, and the role of underlying thyroid disease
title_short Ultrasound detection of normal parathyroid glands: detection rate, topographic anatomy, and the role of underlying thyroid disease
title_sort ultrasound detection of normal parathyroid glands detection rate topographic anatomy and the role of underlying thyroid disease
topic US
normal parathyroids
parathyroid detection
parathyroid imaging
neck ultrasound
url https://www.frontiersin.org/articles/10.3389/fendo.2025.1595940/full
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