Mwewa Tana Bupe, Raeymaeckers Steven
UZ Brussel, Belgium.
J Belg Soc Radiol. 2023 Aug 17;107(1):61. doi: 10.5334/jbsr.3238. eCollection 2023.
We report the case of a 72-year-old patient presenting with recurrent primary hyperparathyroidism after total thyroidectomy and parathyroidectomy with presternal autotransplantation. Methionine-PET-CT proved false-positive and Tc-99m-tetrofosmine imaging false-negative. Using a novel multiphase-4DCT technique we identified an anterior mediastinal nodule demonstrating contrast wash-in and wash-out, suggesting parathyroid adenoma. Traditional 4DCT-protocols obtain fewer phases; therefore, this enhancement pattern might have gone unnoticed. After surgical resection the bloodwork normalized, histopathology confirmed a parathyroid adenoma.
Multiphase 4DCT is a potentially helpful technique for the detection of parathyroid adenomas after total thyroidectomy and parathyroidectomy.
我们报告了一例72岁患者，在全甲状腺切除和甲状旁腺切除并行胸骨前自体移植后出现复发性原发性甲状旁腺功能亢进。蛋氨酸PET-CT结果为假阳性，锝-99m替曲膦显像结果为假阴性。使用一种新型的多期4DCT技术，我们发现了一个前纵隔结节，该结节显示有造影剂流入和流出，提示为甲状旁腺腺瘤。传统的4DCT协议获得的期数较少；因此，这种强化模式可能未被注意到。手术切除后血液检查恢复正常，组织病理学证实为甲状旁腺腺瘤。
多期4DCT是全甲状腺切除和甲状旁腺切除术后检测甲状旁腺腺瘤的一种潜在有用技术。
