Journal article
Preoperative MR imaging in hyperparathyroidism : Results and factors affecting parathyroid detection
American journal of roentgenology (1976), Vol.166(3), pp.705-710
1996
DOI: 10.2214/ajr.166.3.8623655
PMID: 8623655
Abstract
To determine the sensitivity of MR imaging for the detection of abnormal parathyroid glands in patients with biochemical evidence of hyperparathyroidism and to identify the factors affecting detection.
Between 1985, 82 patients with biochemical proof of hyperparathyroidism were referred for MR imaging of the parathyroid glands prior to surgery. Axial T1- (600/20 [TR/TE]) and T2-weighted (2500/40, 80) spin-echo images were obtained using an anterior neck surface coil. The interpretation of the MR image was compared with the findings at surgery and also correlated with gland histology, volume, and weight. Cases in which a false-positive or false-negative diagnosis was made were reviewed to determine the factors affecting detection.
MR imaging detected 71 of 92 (77%) surgically proven abnormal glands (sensitivity, 77%; 95% confidence interval (CI), 68-86%) and misdiagnosed five (1.6%) of 314 normal glands as abnormal. There was no difference in the detection of enlarged glands in patients presenting for the first time (n = 71) (sensitivity, 77%; 95% CI, 66-86%) compared with patients with recurrent hyperparathyroidism (n = 12) (sensitivity, 77%; 95% CI, 46-95%). There was no significant difference in the detection of adenomas (sensitivity, 77%; 95% CI, 65-86%) compared with hyperplasia (sensitivity, 71%; 95% CI, 42-92%). Of five patients with ectopic parathyroid glands (1.6%), four had had previous surgery. All five glands were successfully located (three mediastinal, two in the neck). Factors contributing to a false-negative MR imaging diagnosis included small gland size and thyroid disease. Four of five false-positive diagnoses were due to enlarged lymph nodes being mistaken for parathyroid glands.
MR imaging is an accurate technique for investigation of hyperparathyroidism. Pitfalls include low sensitivity for the identification of small glands, misinterpretation of enlarged lymph nodes as parathyroid adenomas, and misinterpretation because of thyroid disease. MR imaging is particularly useful in the investigation of patients who remain hypercalcemic following initial surgery.
Details
- Title: Subtitle
- Preoperative MR imaging in hyperparathyroidism : Results and factors affecting parathyroid detection
- Creators
- Vincent G McDermott - Department of Diagnostic Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104, United StatesR. J MENDEZ FERNANDEZ - Department of Diagnostic Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104, United StatesThomas J Meakem III - Department of Diagnostic Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104, United StatesA. H STOLPEN - Department of Diagnostic Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104, United StatesC. E SPRITZER - Department of Diagnostic Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104, United StatesWarren B Gefter - Department of Diagnostic Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104, United States
- Resource Type
- Journal article
- Publication Details
- American journal of roentgenology (1976), Vol.166(3), pp.705-710
- DOI
- 10.2214/ajr.166.3.8623655
- PMID
- 8623655
- NLM abbreviation
- AJR Am J Roentgenol
- ISSN
- 0361-803X
- eISSN
- 1546-3141
- Publisher
- American Roentgen Ray Society; Leesburg, VA
- Language
- English
- Date published
- 1996
- Academic Unit
- Radiology; Internal Medicine
- Record Identifier
- 9984051705502771
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