Multiple endocrine neoplasia type 2 echocardiography or ultrasound: Difference between revisions

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===Parathyroid Adenoma===
===Parathyroid Adenoma===
* [[Ultrasound]] is one of most commonly used initial imaging modalities.
* [[Ultrasound]] is one of most commonly used initial imaging modalities.
:* Greyscale
* Most nodules need to be >1cm to be confidently seen on [[ultrasound]]
::* Most nodules need to be >1cm to be confidently seen on [[ultrasound]]
* [[Parathyroid adenoma]]s tend to be homogeneously hypoechoic to the overlying [[thyroid gland]]
::* [[Parathyroid adenoma]]s tend to be homogeneously hypoechoic to the overlying [[thyroid gland]]
* An echogenic [[thyroid]] capsule separating the [[thyroid]] from the [[parathyroid]] may be seen<ref name="pmid20614300">{{cite journal| author=Wieneke JA, Smith A| title=Parathyroid adenoma. | journal=Head Neck Pathol | year= 2008 | volume= 2 | issue= 4 | pages= 305-8 | pmid=20614300 | doi=10.1007/s12105-008-0088-8 | pmc=PMC2807581 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20614300  }} </ref><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>
::* An echogenic [[thyroid]] capsule separating the [[thyroid]] from the [[parathyroid]] may be seen<ref name="pmid20614300">{{cite journal| author=Wieneke JA, Smith A| title=Parathyroid adenoma. | journal=Head Neck Pathol | year= 2008 | volume= 2 | issue= 4 | pages= 305-8 | pmid=20614300 | doi=10.1007/s12105-008-0088-8 | pmc=PMC2807581 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20614300  }} </ref><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>
* Doppler [[ultrasound]]
* Doppler [[ultrasound]]
:* Can commonly show a characteristic extrathyroidal feeding vessel (typically a branch off the inferior thyroidal artery), which enters the [[parathyroid gland]] at one of the poles. Internal vascularity is also commonly seen in a peripheral distribution. This feeding [[artery]] tends to branch around the periphery of the [[gland]] before penetration. This feature can give a characteristic arc or rim of vascularity. The overlying [[thyroid gland]] may also show an area of asymmetric hypervascularity that may help to locate an underlying [[adenoma]].<ref name=Radiopaedia 2015 Parathyroid adenoma>{{cite web | title = Radiopedia 2015 Parathyroid adenoma  [Dr Bruno Di Muzio and Dr Yuranga Weerakkody]| url = http://radiopaedia.org/articles/parathyroid-adenoma }}</ref>
:* Can commonly show a characteristic extrathyroidal feeding vessel (typically a branch off the inferior thyroidal artery), which enters the [[parathyroid gland]] at one of the poles. Internal vascularity is also commonly seen in a peripheral distribution. This feeding [[artery]] tends to branch around the periphery of the [[gland]] before penetration. This feature can give a characteristic arc or rim of vascularity. The overlying [[thyroid gland]] may also show an area of asymmetric hypervascularity that may help to locate an underlying [[adenoma]].<ref name=Radiopaedia 2015 Parathyroid adenoma>{{cite web | title = Radiopedia 2015 Parathyroid adenoma  [Dr Bruno Di Muzio and Dr Yuranga Weerakkody]| url = http://radiopaedia.org/articles/parathyroid-adenoma }}</ref>

Revision as of 03:34, 5 October 2015

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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

Ultrasound scan may be helpful in the diagnosis of multiple endocrine neoplasia type 2. Findings on ultrasound scan suggestive of multiple endocrine neoplasia type 2 include punctate high echogenic foci resembling calcification within the thyroid gland, solid to mixed cystic masses on adrenal gland and homogeneously hypoechoic parathyroid gland.

Ultrasound

Medullary Thyroid Carcinoma

Pheochromocytoma

  • Pheochromocytoma can have a variable appearance ranging from solid to mixed cystic and solid to cystic[2]

Parathyroid Adenoma

  • Can commonly show a characteristic extrathyroidal feeding vessel (typically a branch off the inferior thyroidal artery), which enters the parathyroid gland at one of the poles. Internal vascularity is also commonly seen in a peripheral distribution. This feeding artery tends to branch around the periphery of the gland before penetration. This feature can give a characteristic arc or rim of vascularity. The overlying thyroid gland may also show an area of asymmetric hypervascularity that may help to locate an underlying adenoma.

References

  1. Gorman B, Charboneau JW, James EM, Reading CC, Wold LE, Grant CS; et al. (1987). "Medullary thyroid carcinoma: role of high-resolution US". Radiology. 162 (1 Pt 1): 147–50. doi:10.1148/radiology.162.1.3538147. PMID 3538147.
  2. Leung K, Stamm M, Raja A, Low G (2013). "Pheochromocytoma: the range of appearances on ultrasound, CT, MRI, and functional imaging". AJR Am J Roentgenol. 200 (2): 370–8. doi:10.2214/AJR.12.9126. PMID 23345359.
  3. Wieneke JA, Smith A (2008). "Parathyroid adenoma". Head Neck Pathol. 2 (4): 305–8. doi:10.1007/s12105-008-0088-8. PMC 2807581. PMID 20614300.
  4. 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.

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