Parathyroid MRI Scan

Parathyroid magnetic resonance imaging (MRI) is reserved for cases of primary hyperparathyroidism where properly performed Sestamibi scan and high resolution parathyroid ultrasound did not localize a parathyroid adenoma. A parathyroid MRI is not a routine test.

When looking for enlarged parathyroid glands, an MRI scan is more specific and sensitive than the CAT scan. MRI scans for parathyroid are reserved for patients with recurrent disease who already have had one unsuccessful operation. An MRI for parathyroid may also be performed in referral cases from other institutions where there is persistent hyperparathyroidism after an initial neck exploration. In this case, 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 behind the esophagus. In this case the T2 weighted MRI can be very helpful.

Again, the parathyroid MRI is a reserved test for only difficult cases.

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