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Case Reports
. 2012 May;33(5):949-52.
doi: 10.3174/ajnr.A2885. Epub 2012 Jan 12.

Parathyroid lesions: characterization with dual-phase arterial and venous enhanced CT of the neck

A R Gafton  1 , C M Glastonbury, J D Eastwood, J K Hoang
Affiliations
Case Reports

Parathyroid lesions: characterization with dual-phase arterial and venous enhanced CT of the neck

A R Gafton et al. AJNR Am J Neuroradiol. 2012 May.

Abstract

This clinical report describes the enhancement characteristics of hypersecreting parathyroid lesions on dual-phase neck CT. We retrospectively analyzed the enhancement characteristics of 5 pathologically confirmed PTH-secreting lesions on dual-phase CT examinations. Attenuation values were measured for PTH-secreting lesions, vascular structures (CCA and IJV), and soft tissue structures (thyroid gland, jugulodigastric lymph node, and submandibular gland). From the attenuation values, "relative enhancement washout percentage" and "tissue-vascular ratio" were calculated and compared. All lesions decreased in attenuation from arterial to venous phase, while the mean attenuation values of other soft tissue structures increased. A high relative enhancement washout percentage was correlated with parathyroid lesions (P < .006). The tissue-CCA ratio and tissue-IJV ratio for PTH-secreting lesions in the arterial phase were statistically significantly higher compared with soft tissue structures (P < .05). If these results are validated in future larger studies, noncontrast and delayed venous phases of 4D-CT could be eliminated to markedly reduce radiation exposure.

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Figures

Fig 1.
Fig 1.
Mean enhancement of PTH-secreting lesions compared with other neck soft tissue structures.
Fig 2.
Fig 2.
76-year-old woman with left juxta-thyroid parathyroid hyperplasia. A, Arterial phase image shows the hyperenhancing parathyroid lesion (arrow), which has higher attenuation than the adjacent thyroid gland (arrowhead). B, Venous phase image shows decreased attenuation of the parathyroid lesion (arrow), representing rapid washout of contrast. The adjacent thyroid gland (arrowhead) has higher attenuation than during the arterial phase.
See this image and copyright information in PMC

Comment in

  • Dynamic parathyroid CT: are 2 phases sufficient?
    Sepahdari AR, Harari A. Sepahdari AR, et al. AJNR Am J Neuroradiol. 2012 Apr;33(4):E66; author reply E67. doi: 10.3174/ajnr.A3084. Epub 2012 Mar 22. AJNR Am J Neuroradiol. 2012. PMID: 22442039 Free PMC article. No abstract available.

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