Endocrine Abstracts

Purpose: Our study was intended to describe the typical radiologic features of parathyroid adenoma and correlation study with ^99mTc-sestamibi SPECT findings.

Materials and Methods: A review of a surgical database and electronic medical records from 2012 to 2018 identified the cases of 17 patients who underwent preoperative cervical sonography for primary hyperparathyroidism with subsequent resection of pathologically proven parathyroid adenoma. Two radiologists retrospectively evaluated the preoperative ultrasound images and assessed for morphologic characteristics, size, location, and color Doppler vascularity. ^99mTc-sestamibi SPECT findings, surgical and pathologic reports were reviewed.

Results: Most of the parathyroid adenomas (15/17, 86%) were deep or inferolateral to the adjacent thyroid. An echogenic border separating the adenoma from the overlying thyroid was identified in all cases. 14 cases were solid (82%), one case was solid and cystic, and two cases were cystic (11%) in sonographic morphology. Color Doppler examination of 14 patients showed feeding vessels with internal color flow to the solid components in 7 patients (50%). All patients underwent preoperative ^99mTc-sestamibi SPECT, and the adenoma was definitively localized in 9 patients (52%) and equivocally localized in 6 patients (34%). One case of ectopic mediastinal parathyroid adenoma was identified by ^99mTc-sestamibi SPECT and subsequently confirmed by chest computed tomography.

Conclusion: Awareness of typical radiologic features (location, morphologic characteristics, color Doppler findings) may aid radiologists in preoperative localization of parathyroid adenoma. And ^99mTc-sestamibi SPECT is also helpful to the diagnosis of this tumor.