Gulati Shrea, Chumber Sunil, Puri Gopal, Spalkit Stanzin, Damle N A, Das C J
Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi 110029, Delhi, India.
Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi 110029, Delhi, India.
World J Radiol. 2023 Mar 28;15(3):69-82. doi: 10.4329/wjr.v15.i3.69.
The goal of parathyroid imaging in hyperparathyroidism is not diagnosis, rather it is the localization of the cause of hyperparathyroidism for planning the best therapeutic approach. Hence, the role of imaging to accurately and precisely localize the abnormal parathyroid tissue is more important than ever to facilitate minimally invasive parathyroidectomy over bilateral neck exploration. The common causes include solitary parathyroid adenoma, multiple parathyroid adenomas, parathyroid hyperplasia and parathyroid carcinoma. It is highly imperative for the radiologist to be cautious of the mimics of parathyroid lesions like thyroid nodules and lymph nodes and be able to differentiate them on imaging. The various imaging modalities available include high resolution ultrasound of the neck, nuclear imaging studies, four-dimensional computed tomography (4D CT) and magnetic resonance imaging. Contrast enhanced ultrasound is a novel technique which has been recently added to the armamentarium to differentiate between parathyroid adenomas and its mimics. Through this review article we wish to review the imaging features of parathyroid lesions on various imaging modalities and present an algorithm to guide their radiological differentiation from mimics.
甲状旁腺功能亢进症甲状旁腺成像的目的不是诊断，而是确定甲状旁腺功能亢进症的病因，以便规划最佳治疗方案。因此，成像在准确精确定位异常甲状旁腺组织方面的作用比以往任何时候都更加重要，以促进微创甲状旁腺切除术，而不是双侧颈部探查。常见病因包括孤立性甲状旁腺腺瘤、多发性甲状旁腺腺瘤、甲状旁腺增生和甲状旁腺癌。放射科医生必须高度警惕甲状旁腺病变的类似物，如甲状腺结节和淋巴结，并能够在成像上对它们进行鉴别。可用的各种成像方式包括颈部高分辨率超声、核成像研究、四维计算机断层扫描（4D CT）和磁共振成像。对比增强超声是一种新技术，最近已被添加到诊断方法中，用于区分甲状旁腺腺瘤及其类似物。通过这篇综述文章，我们希望回顾各种成像方式下甲状旁腺病变的成像特征，并提出一种算法，以指导它们与类似物的放射学鉴别。
