MR imaging of parathyroid disease: Initial results and comparison with radionuclide scans

Ascertaining the specific pathology in hyperparathyroidism (HPT) continues to be a difficult diagnostic problem, especially after unsuccessful surgery. Twenty-nine patients with HPT were studied by MR imaging. Twelve were new patients with primary disease, 13 had failed previous surgery, and four had end-stage renal disease. Twenty (19 operated on) underwent thallium imaging and 23 underwent surgery; 21 were found to have adenomas and two had hyperplasia. MR imaging accurately detected and localized the lesions in 67% of patients prospectively and 83% of patients retrospectively. Thallium imaging was accurate in 64% prospectively and 77% retrospectively. Together the two modalities detected 68% of lesions prospectively and 86% retrospectively. Accuracy was similar in patients who did not undergo operation