Parathyroid adenomas studied by digital subtraction angiography

Eighteen patients who had elevated serum calcium and parathormone levels were prospectively studied with intravenous digital subtraction angiography (DSA). Intravenous DSA of the neck and mediastinum was performed in the anteroposterior, the left anterior, and the right anterior oblique projections. The study was considered positive if an abnormal blush or blood supply was noted. Upon operation, 14 patients were confirmed to have parathyroid adenomas, of whom five had positive preoperative DSA examinations. Four patients were followed medically (three negative DSA, one positive DSA). A positive intravenous DSA may be useful to guide neck explorations for parathyroid adenomas; however, the low sensitivity of the study may limit its screening potential.