How to Perform Parathyroid 4D CT: Tips and Traps for Technique and Interpretation

Published Online:https://doi.org/10.1148/radiol.13122661

The radiologist’s ability to detect a candidate lesion and differentiate it from mimics can be increased with appreciation of the typical contrast enhancement characteristics and morphologic features of parathyroid adenomas.

Parathyroid four-dimensional (4D) computed tomography (CT) is an imaging technique for preoperative localization of parathyroid adenomas that involves multidetector CT image acquisition during two or more contrast enhancement phases. Four-dimensional CT offers an alternative or additional tool in the evaluation of primary hyperparathyroidism. The purpose of this article is to describe the 4D CT technique and provide a practical guide to the radiologist for imaging interpretation. The article will discuss the rationale for imaging, approach to interpretation, imaging findings, and pitfalls.

© RSNA, 2014

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Article History

Received December 20, 2012; revision requested January 30, 2013; revision received February 13; accepted March 19; final version accepted April 30.
Published online: Jan 2014
Published in print: Jan 2014