Parathyroid pathologies are suspected based on the biochemical alterations and clinical manifestations, and the predominant roles of imaging in primary hyperparathyroidism are localisation of tumour within parathyroid glands, surgical planning, and to look for any ectopic parathyroid tissue in the setting of recurrent disease. This article provides a comprehensive review of embryology and anatomical variations of parathyroid glands and their clinical relevance, surgical anatomy of parathyroid glands, differentiation between multiglandular parathyroid disease, solitary adenoma, atypical parathyroid tumour, and parathyroid carcinoma. The roles, advantages and limitations of ultrasound, four-dimensional computed tomography (4DCT), radiolabelled technetium-99 (99mTc) sestamibi or dual tracer99mTc pertechnetate and99mTc-sestamibi with or without single photon emission computed tomography (SPECT) or SPECT/CT, dynamic enhanced magnetic resonance imaging (4DMRI), and fluoro-choline positron emission tomography (18F-FCH PET) or [11C] Methionine (11C -MET) PET in the management of parathyroid lesions have been extensively discussed in this article. The role of fluorodeoxyglucose PET (FDG-PET) has also been elucidated in this article. Management guidelines for parathyroid carcinoma proposed by the American Society of Clinical Oncology (ASCO) have also been described. An algorithm for management of parathyroid lesions has been provided at the end to serve as a quick reference guide for radiologists, clinicians and surgeons.
甲状旁腺病变的怀疑基于生化指标改变及临床表现，影像学在原发甲状旁腺功能亢进中的主要作用在于定位腺体内肿瘤、制定手术方案，以及在疾病复发时探查异位甲状旁腺组织。本文系统综述了甲状旁腺胚胎发育与解剖变异及其临床意义、甲状旁腺外科解剖结构，并辨析了多腺体性甲状旁腺疾病、孤立性腺瘤、非典型甲状旁腺肿瘤与甲状旁腺癌的鉴别要点。文中深入探讨了超声、四维计算机断层扫描（4DCT）、放射性核素锝-99标记甲氧异腈（99mTc-MIBI）或双示踪剂99mTc-高锝酸盐与99mTc-MIBI联合单光子发射计算机断层扫描（SPECT）或SPECT/CT、动态增强磁共振成像（4DMRI）、氟胆碱正电子发射断层扫描（18F-FCH PET）及[11C]蛋氨酸（11C-MET）PET在甲状旁腺病变诊疗中的作用与优劣。同时阐明了氟代脱氧葡萄糖PET（FDG-PET）的应用价值，并详述了美国临床肿瘤学会（ASCO）提出的甲状旁腺癌诊疗指南。文末附有甲状旁腺病变诊疗路径图，为放射科医师、临床医生及外科医师提供快速参考。
肿瘤(癌症)患者之家