Abstract
Objectives: To evaluate whether readout-segmented echo-planar imaging
(RS-EPI) diffusion-weighted imaging (DWI) can reduce image distortion
and improve the lesion identification in parathyroid adenomas (PTAs)
compared to single-shot EPI (SS-EPI) DWI, and to determine whether PTAs
can be differentiated from other soft tissue structures of the head and
neck region by using the apparent diffusion coefficient (ADC) value.
Design: Retrospective study. Setting: Kyoto University Hospital.
Participants: 24 patients who underwent a magnetic resonance imaging
(MRI) scan for the preoperative diagnosis of PTAs from January 2012 to
March 2020 were enrolled. Main outcome measures: MRI was performed with
the acquisition of a 1.5T MR imaging system (Avanto or Trio, Siemens,
Erlangen, Germany) or a 3T MR imaging system (Prisma or Skyra, Siemens).
Image quality and distortion of PTAs on RS-EPI and SS-EPI was evaluated
using a reported five point score, and the ADC values of PTAs, thyroid
glands and cervical neck lymph nodes were compared. Results: RS-EPI
provided significantly less distortion but did not improve the lesion
identification compared to SS-EPI. On SS-EPI, the PTAs had significantly
higher ADC values compared to the cervical lymph nodes. On RS-EPI, the
PTAs had significantly higher ADC values compared to the thyroid glands
and cervical lymph nodes. Conclusions: RS-EPI reduces the DWI distortion
in PTAs. The ADC value obtained using RS-EPI enables the differentiation
of PTAs from nearby structures, such as thyroid glands and cervical
lymph nodes.