CT imaging features of the normal parathyroid gland in the dog.

Abstract

Aim of our prospective pilot study was to assess the feasibility of computed tomography (CT) to visualize the normal parathyroid gland in dogs and provide a description of its CT appearance. A total of 25 dogs, which received CT imaging including the neck region for diseases unrelated to the thyroid or parathyroid glands, were enrolled. Inclusion criteria were a normal physical examination, an unremarkable complete blood count and serum chemistry profile. Pre and post contrast CT images were acquired using a 16-slice helical scanner with an 18 cm field of view, 1 mm slice thickness and a 512 × 512 matrix. Post contrast images were obtained 30-45 seconds following contrast medium injection (early venous phase). CT-images were independently reviewed by 2 radiologists. Visibility of the parathyroid gland was recorded and inter-observer agreement was calculated. For all visualized parathyroid glands the following parameters were assessed: size, density in Hounsfield units (HU) on pre and post contrast images, density of the thyroid gland and border definition (excellent, moderate, poor). Only 20 respectively 25 parathyroid glands could be visualized by the 2 observers. The number did not vary between pre and post contrast images. The inter-observer agreement for the identification was fair (κ = 0.40). Length, width and height (mean ± standard deviation) of the parathyroid gland were 4.2 × 2.5 × 2.9 mm ± 1.3 × 0.8 × 1.0 mm. The density was 39.7 ± 20.6 HU on pre contrast images and 103.1 ± 47.1 HU on post contrast images, thus the organ was hypoattenuating compared to the thyroid gland on pre (166.7 ± 34.3 HU) and post contrast (234.0 ± 60.1 HU) images. This study offers the first description of the CT appearance of the presumed normal canine parathyroid gland. However, the overall visibility was poor. Despite the overall poor visibility of the parathyroid gland it was occasionally visible and its CT dimensions were larger as described for ultrasound in this group of dogs, which showed no clinical signs of hyperparathyroidism. Thus, visibility of the parathyroid gland on CT may not necessarily imply parathyroid disease. However, further research is necessary.