Multiple endocrine neoplasia type 2 MRI: Difference between revisions

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:* '''T1'''
:* '''T1'''
::* Typically intermediate to low signal
::* Typically intermediate to low signal
::* Subacute [[hemorrhage]] can cause high signal intensiy<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>
::* 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
::* [[Fibrosis]] or old [[hemorrhage]] can cause low signal intensity
:* '''T2'''
:* '''T2'''

Revision as of 05:37, 5 October 2015

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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:
  • T1
  • 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 MR 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%.[2]
  • 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): this is a helpful feature
  • Areas of necrosis/hemorrhage/calcification will alter signal
  • T1 C+ (Gd)
  • Heterogenous enhancement
  • Enhancement is prolonged, persisting for as long as 50 minutes[3]
  • Image courtesy of Dr Hani Al Salami[4]

    Image courtesy of Dr Hani Al Salami[4]

  • Image courtesy of Dr Frank Gaillard[5]

    Image courtesy of Dr Frank Gaillard[5]

  • Image courtesy of Dr G Balachandran[6]

    Image courtesy of Dr G Balachandran[6]

References

  1. ↑ 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.
  2. ↑ Blake, Michael (2009). Adrenal imaging. Totowa, NJ: Humana Press. ISBN 193411586X.
  3. ↑ Reiser, Maximilian (2008). Magnetic resonance tomography. Berlin: Springer. ISBN 354029354X.
  4. ↑ Image courtesy of Dr Hani Al Salami. Radiopaedia (original file[1]).Creative Commons BY-SA-NC
  5. ↑ Image courtesy of Dr Frank Gaillard. Radiopaedia (original file[2]).Creative Commons BY-SA-NC
  6. ↑ Image courtesy of Dr Frank Gaillard. Radiopaedia (original file[3]).Creative Commons BY-SA-NC

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