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Parathyroid adenomas in the aortopulmonary window
J L Doppman1, M C Skarulis, C C Chen
1Diagnostic Radiology Department, Warren Grant Magnuson Clinical Center, National Institutes of Health, Bethesda, MD 20892-1182, USA.
Radiology
|November 1, 1996
Summary
Sestamibi scintigraphy effectively detects ectopic parathyroid adenomas in the aortopulmonary window. SPECT imaging aids in differentiating these from mediastinal adenomas, with CT and MR also proving useful.
Area of Science:
- Endocrinology
- Nuclear Medicine
- Radiology
Background:
- Ectopic parathyroid adenomas can occur in unusual locations, posing diagnostic challenges.
- The aortopulmonary window is a rare but significant site for ectopic parathyroid tissue.
Purpose of the Study:
- To evaluate the effectiveness of various imaging modalities for localizing ectopic parathyroid adenomas in the aortopulmonary window.
Main Methods:
- Nine patients with ectopic parathyroid tissue in the aortopulmonary window underwent ultrasound, CT, MR imaging, and scintigraphy.
- Diagnostic arteriography and venous sampling were performed in a subset of patients.
Main Results:
- Sestamibi scintigraphy demonstrated 100% sensitivity in detecting these ectopic adenomas.
- CT and MR imaging showed high positive rates (89% and 63%, respectively).
- SPECT imaging successfully distinguished aortopulmonary window adenomas from thymic or anterior mediastinal adenomas.
Conclusions:
- Sestamibi scintigraphy is a highly sensitive method for identifying ectopic parathyroid glands in the aortopulmonary window.
- SPECT, CT, and MR imaging can aid in differentiating these from other mediastinal masses, provided imaging extends below the aortic arch.