THYROID AND PARATHYROID-GLAND PATHOLOGY - ROLE OF IMAGING

There are many imaging modalities available for studying thyroid and p arathyroid masses. For the thyroid gland, the demonstration of a hyper functioning or purely cystic mass by scintigraphy and ultrasound reass ures that a palable nodule is not cancer. Solitary, cold, or solid nod ules often requires biopsy because of suspicion of malignancy. Metabol ic and inflammatory disorders are imaged best with nuclear medicine st udies whereas congenital thyroid lesions are evaluated best with compu ted tomography or MR imaging. Fn the search for a parathyroid adenoma, MR imaging and technetium-99m sestamibi studies appear to be most acc urate, but because of its low cost, ultrasound has a favorable role. I n previously operated patients with persistent hyperparathyroidism, MR imaging is probably most useful, but multiple imaging studies may be needed for definitive localization of adenomas.