Multiple endocrine neoplasia type 2 MRI
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [4]; Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [5]
Overview
MRI scan may be helpful in the diagnosis of multiple endocrine neoplasia type 2. Findings on MRI scan suggestive of multiple endocrine neoplasia type 2 include intermediate to low signal at T1 and hyperintense signal at T2 suggesting parathyroid hyperplasia.
MRI
Parathyroid Carcinoma
- MRI is infrequently utilized in initial work up because of lower spatial resolution and artifacts. Adenomas can show variable signal intensity on MRI. Reported signal characteristics include:[1]
- T1
- Typically intermediate to low signal
- Subacute hemorrhage can cause high signal intensity[2]
- Fibrosis or old hemorrhage can cause low signal intensity
- T2
- Typically hyperintense
- Subacute hemorrhage can cause high signal intensity
- Fibrosis or old hemorrhage can cause low signal intensity
- Since most lesions demonstrate high T2 signal intensity, the addition of contrast for MRI scanning does not significantly increase detection.
Pheochromocytoma
- MRI is the most sensitive modality for identification of pheochromocytomas, and is particularly useful in cases of extra-adrenal location. The overall sensitivity is said to be 98%.[3][1]
- T1
- Slightly hypointense to the remainder of the adrenal
- If necrotic and/or hemorrhagic then signal will be more heterogeneous
- T2
- Markedly hyperintense (lightbulb sign)
- Areas of necrosis/hemorrhage/calcification will alter signal
- T1 C+ (Gd)
- Heterogenous enhancement
- Enhancement is prolonged, persisting for as long as 50 minutes[4]
-
![Image courtesy of Dr Hani Al Salami[5]](/images/b/b4/Pheochromocytoma_CT_3.jpg)
Image courtesy of Dr Hani Al Salami[5]
-
![Image courtesy of Dr Frank Gaillard[6]](/images/3/31/Pheochromocytoma_MRI.jpg)
Image courtesy of Dr Frank Gaillard[6]
-
![Image courtesy of Dr G Balachandran[7]](/images/2/21/Pheochromocytoma_MRI_04.JPG)
Image courtesy of Dr G Balachandran[7]
![Image courtesy of Dr Hani Al Salami[5]](/index.php/File:Pheochromocytoma_CT_3.jpg)
![Image courtesy of Dr Frank Gaillard[6]](/index.php/File:Pheochromocytoma_MRI.jpg)
![Image courtesy of Dr G Balachandran[7]](/index.php/File:Pheochromocytoma_MRI_04.JPG)
References
- ↑ 1.0 1.1 "Radiopedia 2015 Parathyroid adenoma [Dr Bruno Di Muzio and Dr Yuranga Weerakkody]".
- ↑ Johnson NA, Tublin ME, Ogilvie JB (2007). "Parathyroid imaging: technique and role in the preoperative evaluation of primary hyperparathyroidism". AJR Am J Roentgenol. 188 (6): 1706–15. doi:10.2214/AJR.06.0938. PMID 17515397.
- ↑ Blake, Michael (2009). Adrenal imaging. Totowa, NJ: Humana Press. ISBN 193411586X.
- ↑ Reiser, Maximilian (2008). Magnetic resonance tomography. Berlin: Springer. ISBN 354029354X.
- ↑ Image courtesy of Dr Hani Al Salami. Radiopaedia (original file[1]).Creative Commons BY-SA-NC
- ↑ Image courtesy of Dr Frank Gaillard. Radiopaedia (original file[2]).Creative Commons BY-SA-NC
- ↑ Image courtesy of Dr Frank Gaillard. Radiopaedia (original file[3]).Creative Commons BY-SA-NC