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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: https://www.bostonimaging.com/rs85-pr... Click the YouTube Community tab or follow on social media for bonus teaching material posted throughout the week! Website: https://Radquarters.com/ Spotify Video Podcast: https://spoti.fi/462r0F2 Apple Video Podcast: https://apple.co/3ZhHuGu Instagram:   / radquarters   Facebook:   / radquarters   X (Twitter):   / radquarters   Reddit:   / radiologisthq