Parathyroid adenomas: cinearteriography

Parathyroid adenomas in an ectopic location, either the mediastinum or high in the neck, can be relatively easily identified arteriographically because the lesions are separate from the thyroid gland and therefore are not confused with it. However, in most cases in which the adenoma is situated adjacent to thyroid tissue (85%-90%), arteriographic identification, particularly when the lesion is small, may be extremely difficult. Cineangiography during parathyroid arteriography has been found extremely helpful in positive identification of these juxtathyroidal adenomas. Movement of the head from side to side and swallowing maneuvers during cine recording of a selective arteriogram allow determination of the location of a suspicious "blush" in relation to the thyroid gland. As a rule, parathyroid adenomas stain densely in the tissue phase, are nearly always posterior to the thyroid, and separate from thyroid tissue on swallowing. In 10 of 14 parathyroid arteriographic examinations, cinearteriography was useful in confirming or excluding a parathyroid adenoma.
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