ABSTRACT

Diseases or disorders affecting parathyroid glands are hyperparathyroidism, multiple endocrine neoplasia syndromes, parathyroid cysts, and parathyroid carcinoma. The goal of imaging in hyperparathyroidism is not the diagnosis, rather it is the localization of the gland(s) causing hyperparathyroidism for the best treatment approach. The causes resulting in primary hyperparathyroidism include solitary parathyroid adenoma, multiple adenomas, parathyroid hyperplasia, and parathyroid carcinoma. From the imaging perspective, it is extremely important for the radiologists to be cautious of the mimics of parathyroid lesions such as thyroid nodules and  lymph nodes and be able to differentiate them on imaging. The available imaging tools for parathyroid lesion detection include ultrasonography, nuclear scintigraphy, multiphasic computed tomography, four-dimensional computed tomography, magnetic resonance imaging, positron emission tomography-computed tomography, and venous sampling. This article reviews the technical requirements of different imaging modalities for the detection of parathyroid lesions, the imaging features of parathyroid lesions, and helpful tips for distinguishing them from mimicking conditions.