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Axial 4D CT images show that the parathyroid adenomas (circle) are hypoattenuating relative to the thyroid on non–contrast-enhanced images (a, d), are hyperattenuating on the arterial phase images (b, e), and are hypoat-tenuating (washout) on the venous phase images (c, f). kel macau 4d This enhancement pattern is also referred to as type A. hakim 4d