In this radiology lecture, we review the ultrasound appearance of parathyroid adenoma!
Key teaching points include:
* Benign tumor of the parathyroid glands
* Most common cause of primary hyperparathyroidism: Elevated serum calcium and parathyroid hormone (PTH) levels
* Ultrasound: Solid, homogeneous and very hypoechoic. Oval or bean-shaped, long axis oriented craniocaudal. Hypervascular. Majority posterior and inferior to thyroid. Hyperechoic line often separates adenoma from adjacent thyroid. Atypical features: Cystic degeneration, calcification.
* Tc-99m sestamibi: Radiotracer uptake persisting on delayed 2-hour images. Taken up by both thyroid and parathyroid tissue, but washes out more rapidly from thyroid. Greater than 90% predictive value for preoperative localization of parathyroid adenoma. SPECT aids with anatomic localization
* Ectopic locations in up to 5%: Lower neck, mediastinum, retrotracheal/retroesophageal, carotid sheath and intrathyroidal (typically more homogeneous than thyroid nodules and have a linear interface with gland)
* Larger adenomas can be multilobulated
* “Polar vessel” sign: Enlarged feeding artery or draining vein terminating at parathyroid adenoma
To learn more about the Samsung RS85 Prestige ultrasound system, please visit: https://www.bostonimaging.com/rs85-prestige-ultrasound-system-4
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