MRI Parathyroid

Parathyroid MRI is reserved for cases of primary hyperparathyroidism where properly performed Sestamibi scan and high resolution ultrasound did not localize a parathyroid adenoma.  Additionally in referral cases from other institutions where there is persistent hyperparathyroidism after an initial neck exploration, a T2 weighted high resolution MRI of the neck and superior mediastinum would be performed if the Sestamibi and high resolution ultrasound did not definitively identify the adenoma. 

As many competent head and neck surgeons can perform a 4-gland parathyroid exploration; if we are referred a patient for failure to find the adenoma on an initial exploration, it may be located in an abnormal location such as the superior chest or retroesophageal.  In this case the T2 weighted MRI can be very helpful.  Again, this is a reserved test for difficult cases.