Multiple endocrine neoplasia type 2 CT: Difference between revisions
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===Parathyroid Carcinoma=== | ===Parathyroid Carcinoma=== | ||
* Three-dimensional single-photon emission CT (SPECT) is used for preoperative preadenoma localization. | |||
* | ===Pheochromocytoma=== | ||
* CT is the first imaging modality to be used, with an overall sensitivity of 89%. This is on account of 98% of tumors being located within the abdomen and 90% limited to the adrenal glands<ref>{{cite book | last = Blake | first = Michael | title = Adrenal imaging | publisher = Humana Press | location = Totowa, NJ | year = 2009 | isbn = 193411586X }}</ref> | |||
:* Usually large, heterogeneous masses with areas of necrosis and cystic change | |||
they typically enhance avidly<ref name="pmid15486252">{{cite journal| author=Blake MA, Kalra MK, Maher MM, Sahani DV, Sweeney AT, Mueller PR et al.| title=Pheochromocytoma: an imaging chameleon. | journal=Radiographics | year= 2004 | volume= 24 Suppl 1 | issue= | pages= S87-99 | pmid=15486252 | doi=10.1148/rg.24si045506 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15486252 }} </ref> | |||
:* May wash out similar to an adrenal adenoma, but they tend to have greater enhancement in an arterial or portal venous contrast phase | |||
:* Tend to enhance more on the portal venous phase than the arterial phase | |||
* 110 HU of enhancement on the arterial phase is compatible with pheochromocytoma; hypervascular metastases could be considered in an appropriate setting | |||
:* Up to 7% demonstrate areas of calcification<ref>{{cite book | last = Reiser | first = Maximilian | title = Magnetic resonance tomography | publisher = Springer | location = Berlin | year = 2008 | isbn = 354029354X }}</ref> | |||
* An adrenal pheochromocytoma | |||
* It should be noted, that in patients with suspected pheochromocytomas contrast may be contraindicated as it could precipitate a hypertensive crisis. | |||
<gallery> | <gallery> | ||
Image:Pheochromocytoma CT.jpg|PheochromocytomaCase courtesy of Dr Paresh K Desai , <ref>"http://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="http://radiopaedia.org/cases/6819">rID: 6819</ref> | Image:Pheochromocytoma CT.jpg|PheochromocytomaCase courtesy of Dr Paresh K Desai , <ref>"http://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="http://radiopaedia.org/cases/6819">rID: 6819</ref> | ||
Image:Pheochromocytoma CT 2.jpg|Pheochromocytoma Case courtesy of Dr Frank Gaillard, <ref>"http://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="http://radiopaedia.org/cases/6478">rID: 6478</ref> | Image:Pheochromocytoma CT 2.jpg|Pheochromocytoma Case courtesy of Dr Frank Gaillard, <ref>"http://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="http://radiopaedia.org/cases/6478">rID: 6478</ref> |
Revision as of 17:50, 23 September 2015
Multiple endocrine neoplasia type 2 Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [2]
Overview
CT
Medullary Thyroid Carcinoma
- Both primary and metastatic lesions usually have irregular dense calcific foci within.[1]
- In the chest, bullae formation and pulmonary fibrosis might happen as a result of a desmoplastic reaction.
Parathyroid Carcinoma
- Three-dimensional single-photon emission CT (SPECT) is used for preoperative preadenoma localization.
Pheochromocytoma
- CT is the first imaging modality to be used, with an overall sensitivity of 89%. This is on account of 98% of tumors being located within the abdomen and 90% limited to the adrenal glands[2]
- Usually large, heterogeneous masses with areas of necrosis and cystic change
they typically enhance avidly[3]
- May wash out similar to an adrenal adenoma, but they tend to have greater enhancement in an arterial or portal venous contrast phase
- Tend to enhance more on the portal venous phase than the arterial phase
- 110 HU of enhancement on the arterial phase is compatible with pheochromocytoma; hypervascular metastases could be considered in an appropriate setting
- Up to 7% demonstrate areas of calcification[4]
- An adrenal pheochromocytoma
- It should be noted, that in patients with suspected pheochromocytomas contrast may be contraindicated as it could precipitate a hypertensive crisis.
-
PheochromocytomaCase courtesy of Dr Paresh K Desai , [5]
-
Pheochromocytoma Case courtesy of Dr Frank Gaillard, [6]
-
Case courtesy of Dr Roberto Schubert, [7]
-
Case courtesy of Dr Nafisa Shakir Batta, [8]
Reference
- ↑ McCook TA, Putman CE, Dale JK, Wells SA (1982). "Review: Medullary carcinoma of the thyroid: radiographic features of a unique tumor". AJR Am J Roentgenol. 139 (1): 149–55. doi:10.2214/ajr.139.1.149. PMID 7046403.
- ↑ Blake, Michael (2009). Adrenal imaging. Totowa, NJ: Humana Press. ISBN 193411586X.
- ↑ Blake MA, Kalra MK, Maher MM, Sahani DV, Sweeney AT, Mueller PR; et al. (2004). "Pheochromocytoma: an imaging chameleon". Radiographics. 24 Suppl 1: S87–99. doi:10.1148/rg.24si045506. PMID 15486252.
- ↑ Reiser, Maximilian (2008). Magnetic resonance tomography. Berlin: Springer. ISBN 354029354X.
- ↑ "http://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="http://radiopaedia.org/cases/6819">rID: 6819
- ↑ "http://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="http://radiopaedia.org/cases/6478">rID: 6478
- ↑ "http://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="http://radiopaedia.org/cases/16148">rID: 16148
- ↑ "http://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="http://radiopaedia.org/cases/29512">rID: 29512