Ultrasound of Parathyroid Adenoma

In this radiology lecture, we review the ultrasound appearance of parathyroid adenoma!
Key teaching points include:
1) Benign tumor of the parathyroid glands
2) Most common cause of primary hyperparathyroidism: Elevated serum calcium and parathyroid hormone (PTH) levels
3) Ultrasound: Solid, homogeneous and very hypoechoic. Oval or bean-shaped, long axis oriented craniocaudal. Hypervascular. Majority posterior and inferior to thyroid. Hyperechoic line often separates adenoma from adjacent thyroid. Atypical features: Cystic degeneration, calcification
4) Tc-99m sestamibi: Radiotracer uptake persisting on delayed 2-hour images. Taken up by both thyroid and parathyroid tissue, but washes out more rapidly from thyroid. Greater than 90% predictive value for preoperative localization of parathyroid adenoma. SPECT aids with anatomic localization
5) Ectopic locations in up to 5%: Lower neck, mediastinum, retrotracheal/retroesophageal, carotid sheath and intrathyroidal (typically more homogeneous than thyroid nodules and have a linear interface with gland)
6) Larger adenomas can be multilobulated
7) “Polar vessel” sign: Enlarged feeding artery or draining vein terminating at parathyroid adenoma
To learn more about the Samsung RS85 Prestige ultrasound system, please visit: www.bostonimag...
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[@adamguszak7050]

Very good example! Although I think you should explain that parathyroids can be located in many places including intrathyroid, and because of that we can speak about parathyroid change in the thyroid. Also lack of TiRADS which should be 4 in this case. A plus for typing what US system you use, a top one.

[@Radquarters]

Thank you, and excellent points! However, I do actually describe the ectopic locations of parathyroids at time 3:58 in the video, and also that they can mimic TI-RADS 4 nodules at 4:14.

[@adamguszak7050]

@@Radquarters I missed it somehow, my fault, forgive me, do you perform echocardiography as well?

[@Radquarters]

@@adamguszak7050 No problem, and thanks for watching. I don't perform echocardiography. Sorry!

[@nevuspilosus7404]

Thanks. Very nice video.

[@Radquarters]

Thank you, appreciate that :)

[@abdelkrimzaouidi3072]

thank youuuuu from algeria

[@Radquarters]

You're welcome, and great to hear from Algeria!

[@drsayed121]

Thank you❤