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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-prestige-ultrasound-system-4 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: https://www.instagram.com/Radquarters/ Facebook: https://www.facebook.com/Radquarters/ X (Twitter): https://twitter.com/Radquarters Reddit: https://www.reddit.com/user/radiologistHQ/
Ultrasound of Parathyroid Adenoma
In this radiology lecture, we review the ultrasound appearance of parotitis in the pediatric population! Key teaching points include: 1) Parotitis = Inflammation of the parotid glands 2) Acute parotitis is usually infectious, most commonly viral 3) Mumps is most common viral cause in children, often bilateral 4) Bacterial parotitis can cause suppurative parotitis seen in premature infants and immunosuppressed children 5) Acute parotitis on US: Enlarged, heterogeneous, hyperemic gland(s) +/- lymphadenopathy 6) Since can be bilateral, comparison scanning essential 7) Bacterial parotitis may be complicated by abscess 8) “Pomegranate sign” may be seen in setting of acute parotitis: Uniform anechoic foci scattered throughout the gland 9) Juvenile recurrent parotitis (JRP) = Recurrent inflammatory parotitis in children of unknown etiology 10) JRP is rare, but second most common cause of parotitis in childhood after mumps 11) JRP often begins between age 3-6, typically resolves spontaneously after puberty 12) Usually idiopathic, JRP can be presenting symptom of Sjogren’s syndrome, lymphoma, and underlying immunodeficiency 13) JRP on US: May be unilateral or bilateral, multiple hypoechoic foci of salivary secretions scattered throughout the gland +/- central calcifications, color Doppler can be normal 14) Additional causes of parotitis: Sialolithiasis/obstruction, autoimmune (Sjogren syndrome, chronic sclerosing sialadenitis), infectious (HIV, TB), and sarcoidosis (rare in children). To learn more about the Samsung RS85 Prestige ultrasound system, please visit: https://www.bostonimaging.com/rs85-prestige-ultrasound-system-4 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: https://www.instagram.com/Radquarters/ Facebook: https://www.facebook.com/Radquarters/ X (Twitter): https://twitter.com/Radquarters Reddit: https://www.reddit.com/user/radiologistHQ/
Ultrasound of Parotitis
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