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High resolution MRI in the detection of an intrathymic parathyroid adenoma

¹Department of Nuclear Medicine, McGill UniversityDepartments of, ²Radiology and ³Nuclear Medicine, Sir Mortimer B. Davis - Jewish General Hospital, 3755 Côte Ste. Catherine Road, Montreal, Quebec, H3T 1E2, Canada

View larger version (134K): [in a new window]   Figure 1. Anterior planar99Tcm Sestamibi image of the neck and thorax taken 10 min post-tracer injection. There is no focal tracer uptake in the neck region. There is an intense focus of abnormal tracer uptake projecting in the plane of the superior mediastinum consistent with an ectopic parathyroid adenoma.

View larger version (109K): [in a new window]   Figure 2. Axial fat saturatedT2 weighted (repetition time 1714, echo time 80, slice thickness 4 mm, skip 1 mm, matrix 159x256) image through mid thorax with respiratory and cardiac gating using the phased array coil. There is a subcentimetric focus of hyperintensity within the residual atrophic thymic tissue, lying just anterior to the ascending aorta. There is some failure of fat suppression and/or slow flow in veins in the subcarinal mediastinum.

View larger version (97K): [in a new window]   Figure 3. Axial fat saturatedT2 weighted (repetition time 5043, echo time 90, slice thickness 3 mm, skip 0 mm, matrix 256x512) image through mid thorax using the breast coil. There is a 9 mm very clearly defined focus of hyperintensity in the residual thymus tissue of the anterior mediastinum, representing ectopic parathyroid adenoma.