The use and cost-effectiveness of neck scanningprocedures, as we/1 as preoperative evaluation ofsecondary hyperparathyroidism, is a matter of controversyPatients and methods: The retrospective analysisof 21 consecutive patients in the period rangingbetween January 2000 through September 2002with chronic kidney insufficiency and secondaryhyperparathyroidism. Al/ patients were subject toneck ultrasound and scintiscan with preoperativetechnetium 99m sestamibí for the purpose of locatingpathologic parathyroid glands. Al/ of themunderwent surgery. A comparison was made ofthe sensitivity and specificíty of the mentioned studieswith intraoperative findings, and these werecertified by an anatomo-pathologic study.Results: Eighty-two parathyroid glands were resectedas follows: 4 glands in 17 patients, 3 in 3 patientsand 5 in 1 patient. Ultrasound evidenced 48out of the total 82 glands (59%). Scíntiscan showed42 glands (51%). Summation of both methodsshowed 64 different glands (78%). In none of thosecases in which surgery found only 3 glands did thestudies show the 4 glands.Conc/usions: both preoperative evaluation methodsare complementary, and have a very high sensitiveness.The scintiscan by itself has low sensitivityand little use. Surgery in experienced handsmanaged to identify al/ glands, which had goneundetected in the preoperative studies.

La utilidad y costo-efectividad de la imagenologíadel cuello, como evaluación preoperatoria del hiperparatiroidismosecundario, es controversia/.Pacientes y métodos: Se analizaron en, forma retrospectiva,21 pacientes consecutivos en el períodocomprendido entre enero de 2000 y setiembre2002 con insuficiencia renal crónica e hiperparatiroidismosecundario. A todos los pacientes seles realizó ecografía de cuello y centellograma contecnesio 99m sestamibi preoperatorio con el finde localizar las glándulas para tiroides patológicas.Todos fueron sometidos a tratamiento quirúrgico.Se compararon la sensibilidad y especificidad delos estudios mencionados con los hallazgos intraoperatorios,certificando/os mediante estudioanatomopatológico.