Objective To investigate the ultrasonographic characteristics of primary parathyroid adenoma and its correlation with parathyroid hormone(PTH),serum calcium and phosphorus.Methods A total of 185 patients with primary parathyroid adenoma admitted to Fujian Provincial Hospital from January 2015 to December 2021 were selected as the research objects.All patients underwent ultrasound examination,and the relevant clinical information of the patients and the ultrasonic morphological characteristics of the primary parathyroid adenoma,such as size,echo,calcification,liquefaction,full or flat shape,and the location of the lesion were recorded.The correlation of echocardiography,calcification and liquefaction with PTH,serum calcium and phosphorus was analyzed.Results The levels of PTH and serum calcium in patients with liquefaction were higher than those in patients without liquefaction,the differences were statistically significant(P<0.05).There were no significant differences in PTH,serum calcium and serum phosphorus among patients with other different ultrasound characteristics(P>0.05).Correlation analysis showed that PTH and serum calcium levels were positively correlated with adenoma liquefaction(P<0.05),but not with calcification and morphology(P>0.05).Serum phosphorus levels were not significantly correlated with common ultrasound signs(P>0.05).Among 185 patients,9 cases(4.8%)developed hypercalcium crisis.The proportion of liquefaction in patients with high calcium crisis was higher than that in those without,and the difference was statistically significant(P<0.05).Correlation analysis showed that hypercalcium crisis was positively correlated with adenoma liquefaction(P<0.05),but not with echo intensity and calcification(P>0.05).Conclusion There is a certain correlation between the characteristic manifestations of parathyroid adenoma under ultrasound and and main test indicators.Knowledge and understanding can help improve the localization and identification of parathyroid nodules under ultrasound,and at the same time help to screen and prompt primary hyper-parathyroidism patients with potential hypercalcemia crisis,and improve the clinical prognosis of such patients.