title: MR appearance of parathyroid adenomas at 3 T in patients with primary hyperparathyroidism: what radiologists need to know for pre-operative localization.
abstract: OBJECTIVE
  To identify frequent MRI features of parathyroid adenomas (PTAs) in patients with primary hyperparathyroidism (PHPT) using a fast protocol with a 3 T magnet.
  
  
  METHODS
  Thirty-eight patients with PHPT underwent a 3 T-MR. All patients had positive US and Tc-99 sestamibi, for a total number of 46 PTAs. T2-weighted IDEAL-FSE and T1 IDEAL-sequences, before and after contrast, were performed. Five features of PTAs were recognised: hyperintensity, homogeneous or "marbled" appearance and elongated morphology on T2-sequences; cleavage plane from thyroid gland on T2-outphase; rapid enhancement in post-contrast T1. Image quality for T2-weighted IDEAL FSE and usefulness for IDEAL post-contrast T1-weighted and T2-outphase sequences were also graded.
  
  
  RESULTS
  PTAs were hyperintense in T2-sequences in 44/46 (95.7%), "marbled" in 30/46 (65.2%) and elongated in 38/46 (82.6%) patients. Cleavage plane was observed in 36/46 (78.3%), and rapid enhancement in 20/46 (43.5%) patients. T2-sequences showed both excellent fat suppression and image quality (average scores of 3.2 and 3.1). T2-outphase images demonstrated to be quite useful (score 2.8), whereas, post-contrast T1 images showed a lower degree of utility (score 2.4).
  
  
  CONCLUSIONS
  A fast protocol with 3.0-T MRI, recognising most common features of PTAs, may be used as a second-line method in the preoperative detection of PTAs.
  
  
  CONCLUSIONS
  3 T MRI protocol based on T2-weighted IDEAL FSE sequences was used. T2-hyperintensity and elongated morphology are common features of PTAs. 3 T MRI could be used in the preoperative detection of PTAs.
authors.affiliation: Department of Radiological Sciences, Oncology and Pathology, Sapienza University, viale Regina Elena 324, 00161, Rome, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Sacconi
authors.affiliation: Department of Radiological Sciences, Oncology and Pathology, Sapienza University, viale Regina Elena 324, 00161, Rome, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Argirò
authors.affiliation: Department of Radiological Sciences, Oncology and Pathology, Sapienza University, viale Regina Elena 324, 00161, Rome, Italy. daniele.diacinti@uniroma1.it.|Department of Radiological Sciences, Oncology and Pathology, Sapienza Università di Roma, V.le Regina Elena 324, 00161, Roma, Italy. daniele.diacinti@uniroma1.it.
authors.forename: Daniele
authors.initials: D
authors.lastname: Diacinti
authors.affiliation: Department of Radiological Sciences, Oncology and Pathology, Sapienza University, viale Regina Elena 324, 00161, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Iannarelli
authors.affiliation: Department of Radiological Sciences, Oncology and Pathology, Sapienza University, viale Regina Elena 324, 00161, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Bezzi
authors.affiliation: Department of Clinical Sciences, Sapienza University, viale del Policlinico 155, 00161, Rome, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Cipriani
authors.affiliation: Department of Clinical and Molecular Medicine, Sapienza University, via Grottarossa 1035, 00189, Rome, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Pisani
authors.affiliation: Department of Radiological Sciences, Oncology and Pathology, Sapienza University, viale Regina Elena 324, 00161, Rome, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Cipolla
authors.affiliation: Department of Radiological Sciences, Oncology and Pathology, Sapienza University, viale Regina Elena 324, 00161, Rome, Italy.
authors.forename: C
authors.initials: C
authors.lastname: De Felice
authors.affiliation: Department of Clinical Sciences, Sapienza University, viale del Policlinico 155, 00161, Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Minisola
authors.affiliation: Department of Radiological Sciences, Oncology and Pathology, Sapienza University, viale Regina Elena 324, 00161, Rome, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Catalano
mesh_terms: D000236:Adenoma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000150:complications*; D007089:Image Enhancement / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D064847:Multimodal Imaging / Q000379:methods; D009333:Neck / Q000601:surgery; D010282:Parathyroid Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D003287:Contrast Media; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi
keywords: 3 T Magnetic Resonance Imaging; IDEAL sequences; Parathyroid adenoma; Presurgical localisation; Primary hyperparathyroidism