Localization of Parathyroid Disease in Reoperative Patients with Primary Hyperparathyroidism

Figure 2

Hyperfunctioning autotransplanted parathyroid remnant. A 50-year-old male with multiple endocrine neoplasia type 1 (MEN1) presents with recurrent disease after prior parathyroidectomy. Axial (a) and coronal (b) four-dimensional computed tomography (4DCT) images show an irregular enhancing focus (white arrows) superficial to the left SCM muscle, lateral to a surgical clip (red arrow). Planar immediate (c) (20 minutes) and delayed (d) (two hours) single-photon emission computed tomography (SPECT) images demonstrate focal radiotracer accumulation (white arrows) in the left lateral neck that persists on delayed images and confirms the diagnosis of the hyperfunctioning parathyroid gland.

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