Multiple endocrine neoplasia type 2 MRI
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [2]
Overview
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
- Typically intermediate to low signal
- Subacute haemorrhage can cause high signal intensiy[1]
- Fibrosis or old haemorrhage can cause low signal intensity
- T2
- Typically hyperintense
- Subacute haemorrhage can cause high signal intensity
- Fibrosis or old haemorrhage 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 haemorrhagic then signal will be more heterogeneous
- T2
- Markedly hyperintense (lightbulb sign): this is a helpful feature
- Areas of necrosis/haemorrhage/calcification will alter signal
- T1 C+ (Gd)
- Heterogenous enhancement
- Enhancement is prolonged, persisting for as long as 50 minutes[3]
-
![Case courtesy of Dr Hani Al Salam, [4]. From the case [5]](/images/b/b4/Pheochromocytoma_CT_3.jpg)
-
![Case courtesy of Dr Frank Gaillard, [6]. From the case [7]](/images/3/31/Pheochromocytoma_MRI.jpg)
-
![Case courtesy of Dr G Balachandran, [8]](/images/2/21/Pheochromocytoma_MRI_04.JPG)
Case courtesy of Dr G Balachandran, [8]
![Case courtesy of Dr Hani Al Salam, [4]. From the case [5]](/index.php/File:Pheochromocytoma_CT_3.jpg)
![Case courtesy of Dr Frank Gaillard, [6]. From the case [7]](/index.php/File:Pheochromocytoma_MRI.jpg)
![Case courtesy of Dr G Balachandran, [8]](/index.php/File:Pheochromocytoma_MRI_04.JPG)
References
- ↑ 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.
- ↑ "http://radiopaedia.org/">Radiopaedia.org
- ↑ "http://radiopaedia.org/cases/8550">rID: 8550
- ↑ "http://radiopaedia.org/">Radiopaedia.org
- ↑ "http://radiopaedia.org/cases/9920">rID: 9920
- ↑ "http://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="http://radiopaedia.org/cases/10249">rID: 10249