Work in progress: abnormal parathyroid glands. Comparison of nonselective arterial digital arteriography, selective parathyroid arteriography, and venous digital arteriography as methods of detection.
Nonselective arterial digital arteriography (NSADA), selective parathyroid arteriography (SPA), and venous digital arteriography (VDA) were compared as methods of detecting parathyroid enlargement in 14 patients with primary hyperparathyroidism undergoing preoperative localization following unsuccessful neck surgery. All 14 had SPA and NSADA, consisting of contrast injections into the ascending aorta, innominate artery, and left subclavian artery; 7 also had VDA. Surgery was performed in 9 patients, and 2 additional glands were confirmed by fine-needle aspiration and venous sampling. Parathyroid glands could not be located in 3 patients, who were not re-explored. SPA demonstrated 11/13 abnormal glands (85%). NSADA detected 7/13 (54%), and there were 2 false positives. VDA showed 5/6 glands detected by NSADA (83%); the seventh patient did not have VDA. The overall quality of VDA was inferior to NSADA. Although NSADA and VDA are less sensitive than SPA, they are safer and easier to perform and should be the initial vascular screening procedures following unsuccessful parathyroid surgery.
D000328:Adult; D000368:Aged; D000792:Angiography / Q000379:methods*; D003201:Computers; D003287:Contrast Media / Q000008:administration & dosage; D003626:Data Display; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000000981:diagnostic imaging / Q000601:surgery; D006961:Hyperparathyroidism / Q000000981:diagnostic imaging; D007669:Kidney Calculi / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009377:Multiple Endocrine Neoplasia / Q000098:blood supply / Q000601:surgery; D010279:Parathyroid Diseases / Q000000981:diagnostic imaging*; D010280:Parathyroid Glands / Q000098:blood supply* / Q000601:surgery
D003287:Contrast Media