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European Radiology
Published in: European Radiology 3/2016

01-03-2016 | Magnetic Resonance

MR appearance of parathyroid adenomas at 3 T in patients with primary hyperparathyroidism: what radiologists need to know for pre-operative localization

Authors: B. Sacconi, R. Argirò, Daniele Diacinti, A Iannarelli, M. Bezzi, C. Cipriani, D. Pisani, V. Cipolla, C. De Felice, S. Minisola, C. Catalano

Published in: European Radiology | Issue 3/2016

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Abstract

Objectives

To identify frequent MRI features of parathyroid adenomas (PTAs) in patients with primary hyperparathyroidism (PHPT) using a fast protocol with a 3 T magnet.

Methods

Thirty-eight patients with PHPT underwent a 3 T-MR. All patients had positive US and Tc-99 sestamibi, for a total number of 46 PTAs. T2-weighted IDEAL-FSE and T1 IDEAL-sequences, before and after contrast, were performed. Five features of PTAs were recognised: hyperintensity, homogeneous or "marbled" appearance and elongated morphology on T2-sequences; cleavage plane from thyroid gland on T2-outphase; rapid enhancement in post-contrast T1. Image quality for T2-weighted IDEAL FSE and usefulness for IDEAL post-contrast T1-weighted and T2-outphase sequences were also graded.

Results

PTAs were hyperintense in T2-sequences in 44/46 (95.7 %), "marbled" in 30/46 (65.2 %) and elongated in 38/46 (82.6 %) patients. Cleavage plane was observed in 36/46 (78.3 %), and rapid enhancement in 20/46 (43.5 %) patients. T2-sequences showed both excellent fat suppression and image quality (average scores of 3.2 and 3.1). T2-outphase images demonstrated to be quite useful (score 2.8), whereas, post-contrast T1 images showed a lower degree of utility (score 2.4).

Conclusions

A fast protocol with 3.0-T MRI, recognising most common features of PTAs, may be used as a second-line method in the preoperative detection of PTAs.

Key Points

• 3 T MRI protocol based on T2-weighted IDEAL FSE sequences was used.
• T2-hyperintensity and elongated morphology are common features of PTAs.
• 3 T MRI could be used in the preoperative detection of PTAs.
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Metadata
Title
MR appearance of parathyroid adenomas at 3 T in patients with primary hyperparathyroidism: what radiologists need to know for pre-operative localization
Authors
B. Sacconi
R. Argirò
Daniele Diacinti
A Iannarelli
M. Bezzi
C. Cipriani
D. Pisani
V. Cipolla
C. De Felice
S. Minisola
C. Catalano
Publication date
01-03-2016
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 3/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-015-3854-5

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