Preoperative localization diagnosis of parathyroid adenomas in 72 cases of primary hyperparathyroidism by selective catheterization of neck veins and parathyroid hormone determination
Kruse, H.P.; Kuhlencordt, F.; Ringe, J.D.; Vogel, H.; Montz, R.; Koch, G.
Schweizerische Medizinische Wochenschrift 113(17): 636-640
1983
ISSN/ISBN: 0036-7672 PMID: 6867653 Document Number: 219378
In 72 cases of primary hyperparathyroidism, selective venous catheterization was performed preoperatively to localize parathyroid adenomas. Diagnosis of primary hyperparathyroidism was proved by operation in all but 5 cases, in which no adenomas could be found intraoperatively. By venous catheterization of the neck and upper region of the thorax, an average of 10 blood samples per patient were taken. Parathyroid hormone was estimated by radioimmunoassay with high sensitivity against the intact PTH-molecule and carboxy-terminal fragments. Only in 24 out of 72 cases was localization of parathyroid adenomas prognosticated correctly with respect to side and height, while in a total of 38 cases localization on the right or left side only could be determined preoperatively. These unsatisfactory results can be improved only by a much more extensive catheterization technic which would be justified only in patients already operated on before without success. The final evaluation of non-invasive methods, e.g. ultrasonics and computerized tomography, is still under discussion.