Hyperparathyroidism MRI
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Anmol Pitliya, M.B.B.S. M.D.[2]
Overview
MRI may be helpful in the post-operative evaluation of hyper functioning parathyroid glands, particularly in patients with recurrent or persistent hyperparathyroidism. MRI has similar sensitivity and positive predictive value as Tc-99m sestamibi scintigraphy for post-operative detection of hyper-functioning parathyroid glands. MRI with gadolinium and fat suppression is used for detection of ectopic parathyroid adenoma (particularly those located in mediastinum).
MRI
- MRI may be helpful in the post-operative evaluation of hyper functioning parathyroid glands, particularly in patients with recurrent or persistent hyperparathyroidism.[1]
- MRI has similar sensitivity and positive predictive value as Tc-99m sestamibi scintigraphy for post-operative detection of hyper-functioning parathyroid glands. Both test can to combined to obtain a significant increase in sensitivity and positive predictive value.[2]
- MRI with gadolinium and fat suppression is used for detection of ectopic parathyroid adenoma (particularly those located in mediastinum).[3]
- Findings on MRI suggestive of/diagnostic of ectopic parathyroid adenoma include:
- Low in signal intensity on T1-weighted images
- High in signal intensity on T2-weighted images
- Enhancement post introduction of gadolinium
- Intraoperative MRI may be used in conjunction with a navigation system (e.g. endoscopic navigation) for intraoperative identification of parathyroid adenomas. The technique is particularly useful in ectopic parathyroid tissue or re-operation.[4]
- MRI has a sensitivity of 42% to 82% for detection of hyper-functioning parathyroid tissue.[5][6]
References
- ↑ Udelsman R, Pasieka JL, Sturgeon C, Young JE, Clark OH (2009). "Surgery for asymptomatic primary hyperparathyroidism: proceedings of the third international workshop". J Clin Endocrinol Metab. 94 (2): 366–72. doi:10.1210/jc.2008-1761. PMID 19193911.
- ↑ Gotway MB, Reddy GP, Webb WR, Morita ET, Clark OH, Higgins CB (2001). "Comparison between MR imaging and 99mTc MIBI scintigraphy in the evaluation of recurrent of persistent hyperparathyroidism". Radiology. 218 (3): 783–90. doi:10.1148/radiology.218.3.r01fe38783. PMID 11230657.
- ↑ Weber AL, Randolph G, Aksoy FG (2000). "The thyroid and parathyroid glands. CT and MR imaging and correlation with pathology and clinical findings". Radiol Clin North Am. 38 (5): 1105–29. PMID 11054972.
- ↑ Jayender J, Lee TC, Ruan DT (2015). "Real-Time Localization of Parathyroid Adenoma during Parathyroidectomy". N Engl J Med. 373 (1): 96–8. doi:10.1056/NEJMc1415448. PMC 4594796. PMID 26132962.
- ↑ Wakamatsu H, Noguchi S, Yamashita H, Yamashita H, Tamura S, Jinnouchi S; et al. (2003). "Parathyroid scintigraphy with 99mTc-MIBI and 123I subtraction: a comparison with magnetic resonance imaging and ultrasonography". Nucl Med Commun. 24 (7): 755–62. doi:10.1097/01.mnm.0000080246.50447.7d. PMID 12813193.
- ↑ Lopez Hänninen E, Vogl TJ, Steinmüller T, Ricke J, Neuhaus P, Felix R (2000). "Preoperative contrast-enhanced MRI of the parathyroid glands in hyperparathyroidism". Invest Radiol. 35 (7): 426–30. PMID 10901104.