不同超声技术对不同程度继发性甲状旁腺机能亢进的价值

Value of different ultrasound techniques for different degrees of secondary hyperparathyroidism

目的探讨不同程度的继发性甲状旁腺功能亢进(SHPT)在不同超声技术下成像特点。方法本研究为回顾性研究,选取2021年1—9月北部战区总医院超声诊断科收治的22例甲状旁腺切除患者(经超声检测病灶数为68枚,经病理证实均为增生结节),男14例,女8例,年龄(47.71±9.52)岁,年龄范围为31~62岁。根据甲状旁腺素(PTH)分为轻度组(PTH≤1000 pg/ml,n=7)、中度组(1000 pg/ml<PTH≤1800 pg/ml,n=10)及重度组(PTH>1800 pg/ml,n=5)三组,观察并比较三组一般资料、常规超声征象、应变式弹性成像五分法及剪切波弹性成像技术(SWE)参数。结果三组患者的性别及透析时间比较,差异有统计学意义(P<0.05);三组患者增生的甲状旁腺最大径情况、血流分布情况、钙化情况比较,差异有统计学意义(P<0.05)。三组患者应变式弹性成像五分法评分比较,差异有统计学意义(P<0.05)。结论不同程度的SHPT超声特征及弹性成像特征有所不同。应变式弹性成像及剪切波弹性成像作为无创手段,可以通过弹性评分及SWE参量反映增生腺体的硬度情况,给予临床治疗参考性建议。

Objective To explore imaging characteristics of different degrees of secondary hyperparathyroidism(SHPT)based on different ultrasound techniques.Methods This study was a retrospective study,a total of 22 patients with underwent parathyroid removal from January to September in 2021,the total number of ultrasound-detected lesions in 22 patients was 68,all of which were pathologically confirmed to be hyperplastic nodules.including 14 males and 8 females,aged(47.71±9.52)years old,ranging from 31 to 62 years old.According to the level of parathyroid hormone(PTH),patients are divided into three groups,mild group(PTH≤1000 pg/ml),moderate group(1000 pg/ml<PTH≤1800 pg/ml)and severe group(PTH>1800 pg/ml).Observe and compare the two-dimensional ultrasound characteristics,strain elasticity score and shear wave elastic imaging parameters of three groups of lesions.Results The gender and dialysis time of the three groups were compared,the difference was statistically significant(P<0.05).The maximum diameter,blood flow distribution and calcification of hyperplastic parathyroid glands were compared among the three groups,the difference was statistically significant(P<0.05).Three groups of patients strain elastography five score comparison,the difference was statistically significant(P<0.05).Conclusions The ultrasound characteristics and elastography characteristics of different degrees of secondary hyperparathyroidism are different.Strain elastography and shear wave elastography are non-invasive methods that can reflect the hardness of hyperplastic glands through elasticity score and SWE parameters and give clinical treatment recommendations.