原发性和继发性甲状旁腺功能亢进患者的剪切波弹性成像
Shear Wave Elastography in Patients with Primary and Secondary Hyperparathyroidism.
作者信息
Amzar Daniela, Cotoi Laura, Sporea Ioan, Timar Bogdan, Schiller Oana, Schiller Adalbert, Borlea Andreea, Pop Nicusor Gheorghe, Stoian Dana
机构信息
Endocrinology Department, "Victor Babes" University of Medicine and Pharmacy Timisoara, 2nd Eftimie Murgu Square, 300041 Timisoara, Romania.
PhD School Department, "Victor Babes" University of Medicine and Pharmacy Timisoara, 2nd Eftimie Murgu Square, 300041 Timisoara, Romania.
出版信息
J Clin Med. 2021 Feb 10;10(4):697. doi: 10.3390/jcm10040697.
OBJECTIVES
In this study, we aim to determine the elastographic characteristics of both primary and secondary hyperparathyroidism using shear wave elastography. We also aim to evaluate the elastographic differences between them, as well as the differences between the parathyroid, thyroid, and muscle tissue, in order to better identify a cutoff value for the parathyroid tissue.
METHODS
In this prospective study, we examined a total of 68 patients with hyperparathyroidism, divided into two groups; one group consisted of 27 patients with primary hyperparathyroidism and the other group consisted of 41 selected patients with confirmed secondary hyperparathyroidism. The elasticity index (EI) was determined in the parathyroid, thyroid, and muscle tissue. The determined values were compared to better identify the parathyroid tissue.
RESULTS
The median value of mean SWE values measured for parathyroid adenomas from primary hyperparathyroidism was 4.86 kPa. For secondary hyperparathyroidism, the median value of mean SWE was 6.96 KPa. The median (range) presurgical values for parathormone (PTH) and calcium were 762.80 pg/mL (190, 1243) and 9.40 mg/dL (8.825, 10.20), respectively. We identified significant elastographic differences between the two groups ( < 0.001), which remained significant after adjusting elastographic measures to the nonparametric parameters, such as the parathormone value and vitamin D ( < 0.001). The cutoff values found for parathyroid adenoma were 5.96 kPa and for parathyroid tissue 9.58 kPa.
CONCLUSIONS
Shear wave elastography is a helpful tool for identifying the parathyroid tissue, in both cases of primary and secondary hyperparathyroidism, as there are significant differences between the parathyroid, thyroid, and muscle tissue. We found a global cutoff value for the parathyroid tissue of 9.58 kPa, but we must keep in mind that there are significant elastographic differences between cutoffs for primary and secondary hyperparathyroidism.
目的
在本研究中，我们旨在使用剪切波弹性成像来确定原发性和继发性甲状旁腺功能亢进症的弹性成像特征。我们还旨在评估它们之间的弹性成像差异，以及甲状旁腺、甲状腺和肌肉组织之间的差异，以便更好地确定甲状旁腺组织的临界值。
方法
在这项前瞻性研究中，我们共检查了68例甲状旁腺功能亢进症患者，分为两组；一组由27例原发性甲状旁腺功能亢进症患者组成，另一组由41例确诊的继发性甲状旁腺功能亢进症患者组成。在甲状旁腺、甲状腺和肌肉组织中测定弹性指数（EI）。比较所测定的值以更好地识别甲状旁腺组织。
结果
原发性甲状旁腺功能亢进症甲状旁腺腺瘤的平均剪切波弹性成像（SWE）值的中位数为4.86 kPa。对于继发性甲状旁腺功能亢进症，平均SWE的中位数为6.96 KPa。甲状旁腺激素（PTH）和钙的术前值中位数（范围）分别为762.80 pg/mL（190，1243）和9.40 mg/dL（8.825，10.20）。我们发现两组之间存在显著的弹性成像差异（<0.001），在将弹性成像测量值调整为非参数参数（如甲状旁腺激素值和维生素D）后，差异仍然显著（<0.001）。甲状旁腺腺瘤的临界值为5.96 kPa，甲状旁腺组织的临界值为9.58 kPa。
结论
剪切波弹性成像对于识别原发性和继发性甲状旁腺功能亢进症病例中的甲状旁腺组织是一种有用的工具，因为甲状旁腺、甲状腺和肌肉组织之间存在显著差异。我们发现甲状旁腺组织的总体临界值为9.58 kPa，但我们必须记住，原发性和继发性甲状旁腺功能亢进症的临界值之间存在显著的弹性成像差异。
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