The complementary roles of fast spin-echo MR imaging and double-phase 99m Tc-sestamibi scintigraphy for localization of hyperfunctioning parathyroid glands

AJR. American Journal of Roentgenology
V S LeeG S Leight

Abstract

Our purpose was to evaluate and compare prospectively fast spin-echo MR imaging and double-phase technetium-99m-sestamibi scintigraphy for preoperative localization of hyperfunctioning parathyroid glands in high-risk surgical patients. Twenty-five patients, including 17 with a history of neck surgery, underwent preoperative MR imaging and technetium-99m-sestamibi scintigraphy. Initial interpretation of each study was made independently by two radiologists and then done in combination. At surgery, the location, weight, and dimensions, as well as detailed histopathologic evaluations, of all excised glands were recorded. All but two patients became normocalcemic after surgery. MR and sestamibi imaging revealed 31 of 37 (84%) and 29 of 37 (79%) of all abnormal glands, respectively. Sensitivities of MR and sestamibi imaging were higher for adenomas (17 of 18 [94%] and 16 of 18 [89%], respectively) than for hyperplastic glands (14 of 19 [74%] and 13 of 19 [68%], respectively). The specificity of sestamibi imaging (94%) exceeded that of MR imaging (75%). All ectopic glands (n = 8) were correctly localized by both techniques. Glands with atypical MR imaging characteristics (isointense or hyperintense to normal thyroid on T1-weighted sp...Continue Reading

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