Multiple endocrine neoplasia type 2 MRI: Difference between revisions
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{{Multiple endocrine neoplasia type 2}} | {{Multiple endocrine neoplasia type 2}} | ||
{{CMG}}; {{AE}} {{Ammu}} | {{CMG}}; {{AE}} {{Ammu}} | ||
==Overview== | ==Overview== | ||
[[MRI]] scan may be helpful in the [[diagnosis]] of multiple endocrine neoplasia type 2. Findings on [[MRI]] scan suggestive of multiple endocrine neoplasia type 2 include intermediate to low signal at T1 and hyperintense signal at T2 suggesting [[Hyperparathyroidism|parathyroid hyperplasia]]. | |||
==MRI== | ==MRI== | ||
* MRI is sensitive for | ===Parathyroid Carcinoma=== | ||
* [[MRI]] is infrequently utilized in initial work up because of lower [[Angular resolution|spatial resolution]] and artifacts. [[Adenoma]]s can show [[variable]] signal [[Intensity (physics)|intensity]] on [[MRI]]. Reported signal characteristics include:<ref name="Radiopaedia">{{cite web | title = Radiopedia 2015 Parathyroid adenoma [Dr Bruno Di Muzio and Dr Yuranga Weerakkody]| url = http://radiopaedia.org/articles/parathyroid-adenoma }}</ref> | |||
:* '''T1''' | |||
::* Typically intermediate to low signal | |||
::* Subacute [[hemorrhage]] can cause high signal [[intensity]]<ref name="pmid17515397">{{cite journal| author=Johnson NA, Tublin ME, Ogilvie JB| title=Parathyroid imaging: technique and role in the preoperative evaluation of primary hyperparathyroidism. | journal=AJR Am J Roentgenol | year= 2007 | volume= 188 | issue= 6 | pages= 1706-15 | pmid=17515397 | doi=10.2214/AJR.06.0938 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17515397 }} </ref> | |||
::* [[Fibrosis]] or old [[hemorrhage]] can cause low signal intensity | |||
:* '''T2''' | |||
::* Typically hyperintense | |||
::* Subacute [[hemorrhage]] can cause high signal [[intensity]] | |||
::* [[Fibrosis]] or old [[hemorrhage]] can cause low signal intensity | |||
* Since most [[Lesion|lesions]] demonstrate high T2 signal [[Intensity (physics)|intensity]], the addition of contrast for MRI scanning does not significantly increase detection. | |||
===Pheochromocytoma=== | |||
* [[MRI]] is the most sensitive modality for identification of [[pheochromocytoma]]s, and is particularly useful in cases of extra-[[adrenal]] location. The overall sensitivity is said to be 98%.<ref>{{cite book | last = Blake | first = Michael | title = Adrenal imaging | publisher = Humana Press | location = Totowa, NJ | year = 2009 | isbn = 193411586X }}</ref><ref name="Radiopaedia">{{cite web | title = Radiopedia 2015 Pheochromocytoma [Dr Matt A. Morgan and Dr Frank Gaillard]| url = http://radiopaedia.org/articles/pheochromocytoma-2 }}</ref> | |||
* '''T1''' | |||
:* Slightly hypointense to the remainder of the [[adrenal]] | |||
:* If [[Necrosis|necrotic]] and/or [[hemorrhagic]] then signal will be more [[heterogeneous]] | |||
* '''T2''' | |||
:* Markedly hyperintense (lightbulb [[Sign language|sign]]) | |||
:* Areas of [[necrosis]]/[[hemorrhage]]/[[calcification]] will alter signal | |||
* '''T1 C+ (Gd)''' | |||
:* Heterogenous enhancement | |||
:* Enhancement is prolonged, persisting for as long as 50 minutes<ref>{{cite book | last = Reiser | first = Maximilian | title = Magnetic resonance tomography | publisher = Springer | location = Berlin | year = 2008 | isbn = 354029354X }}</ref> | |||
<gallery> | <gallery> | ||
Image:Pheochromocytoma CT 3.jpg| | Image:Pheochromocytoma CT 3.jpg|Image courtesy of Dr Hani Al Salami<ref name=radio01>Image courtesy of Dr Hani Al Salami. [http://www.radiopaedia.org Radiopaedia] (original file[http://radiopaedia.org/cases/8550‘’here’’]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref> | ||
[http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref> | |||
Image:Pheochromocytoma MRI.jpg|Image courtesy of Dr Frank Gaillard<ref name=radio02>Image courtesy of Dr Frank Gaillard. [http://www.radiopaedia.org Radiopaedia] (original file[http://radiopaedia.org/cases/9920‘’here’’]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref> | |||
[http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref> | |||
Image:Pheochromocytoma MRI 04.JPG|Image courtesy of Dr G Balachandran<ref name=radio03>Image courtesy of Dr Frank Gaillard. [http://www.radiopaedia.org Radiopaedia] (original file[http://radiopaedia.org/cases/10249‘’here’’]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref> | |||
[http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref> | |||
</gallery> | </gallery> | ||
==References== | |||
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Latest revision as of 20:29, 13 June 2019
Multiple endocrine neoplasia type 2 Microchapters |
Differentiating Multiple endocrine neoplasia type 2 from other Diseases |
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Multiple endocrine neoplasia type 2 MRI On the Web |
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Directions to Hospitals Treating Multiple endocrine neoplasia type 2 |
Risk calculators and risk factors for Multiple endocrine neoplasia type 2 MRI |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [4]; Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [5]
Overview
MRI scan may be helpful in the diagnosis of multiple endocrine neoplasia type 2. Findings on MRI scan suggestive of multiple endocrine neoplasia type 2 include intermediate to low signal at T1 and hyperintense signal at T2 suggesting parathyroid hyperplasia.
MRI
Parathyroid Carcinoma
- MRI is infrequently utilized in initial work up because of lower spatial resolution and artifacts. Adenomas can show variable signal intensity on MRI. Reported signal characteristics include:[1]
- T1
- Typically intermediate to low signal
- Subacute hemorrhage can cause high signal intensity[2]
- Fibrosis or old hemorrhage can cause low signal intensity
- T2
- Typically hyperintense
- Subacute hemorrhage can cause high signal intensity
- Fibrosis or old hemorrhage can cause low signal intensity
- Since most lesions demonstrate high T2 signal intensity, the addition of contrast for MRI scanning does not significantly increase detection.
Pheochromocytoma
- MRI is the most sensitive modality for identification of pheochromocytomas, and is particularly useful in cases of extra-adrenal location. The overall sensitivity is said to be 98%.[3][1]
- T1
- Slightly hypointense to the remainder of the adrenal
- If necrotic and/or hemorrhagic then signal will be more heterogeneous
- T2
- Markedly hyperintense (lightbulb sign)
- Areas of necrosis/hemorrhage/calcification will alter signal
- T1 C+ (Gd)
- Heterogenous enhancement
- Enhancement is prolonged, persisting for as long as 50 minutes[4]
-
Image courtesy of Dr Hani Al Salami[5]
-
Image courtesy of Dr Frank Gaillard[6]
-
Image courtesy of Dr G Balachandran[7]
References
- ↑ 1.0 1.1 "Radiopedia 2015 Parathyroid adenoma [Dr Bruno Di Muzio and Dr Yuranga Weerakkody]".
- ↑ Johnson NA, Tublin ME, Ogilvie JB (2007). "Parathyroid imaging: technique and role in the preoperative evaluation of primary hyperparathyroidism". AJR Am J Roentgenol. 188 (6): 1706–15. doi:10.2214/AJR.06.0938. PMID 17515397.
- ↑ Blake, Michael (2009). Adrenal imaging. Totowa, NJ: Humana Press. ISBN 193411586X.
- ↑ Reiser, Maximilian (2008). Magnetic resonance tomography. Berlin: Springer. ISBN 354029354X.
- ↑ Image courtesy of Dr Hani Al Salami. Radiopaedia (original file[1]).Creative Commons BY-SA-NC
- ↑ Image courtesy of Dr Frank Gaillard. Radiopaedia (original file[2]).Creative Commons BY-SA-NC
- ↑ Image courtesy of Dr Frank Gaillard. Radiopaedia (original file[3]).Creative Commons BY-SA-NC