Parathyroid Lesions: Characterization with Dual-Phase Arterial and Venous Enhanced CT of the Neck

• Published in: American journal of neuroradiology : AJNR Vol. 33; no. 5; pp. 949 - 952
• Main Authors: GAFTON, A. R, GLASTONBURY, C. M, EASTWOOD, J. D, HOANG, J. K
• Format: Journal Article
• Language: English
• Published: Oak Brook, IL American Society of Neuroradiology 01.05.2012
• Subjects: Adolescent; Aged; Biological and medical sciences; Cerebrospinal fluid. Spinal cord. Spinal roots. Spinal nerves; Contrast Media - administration & dosage; Contrast Media - pharmacokinetics; Female; Head and Neck; Humans; Injections, Intra-Arterial; Injections, Intravenous; Investigative techniques, diagnostic techniques (general aspects); Lymph nodes; Medical sciences; Metabolic Clearance Rate; Middle Aged; Neck; Neck - diagnostic imaging; Nervous system; Neuroimaging; Neurosurgery; Parathyroid; Parathyroid Neoplasms - diagnostic imaging; Parathyroid Neoplasms - metabolism; Radiation; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Radiography; Reproducibility of Results; Sensitivity and Specificity; Soft tissues; Submandibular gland; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Thyroid; Nervous system diseases; Computerized axial tomography; Neck; Radiodiagnosis
• ISSN: 0195-6108; 1936-959X
• DOI: 10.3174/ajnr.A2885

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.