剪切波弹性成像对甲状腺癌术后放射性碘治疗损伤唾液腺腺体的评估

Evaluation of shear wave elasto-graphy for salivary gland injury induced by radioiodine iodine after thyroid cancer surgery

目的:探讨剪切波弹性成像(SWE)对甲状腺乳头状癌(PTC)术后放射性碘(RAI)治疗损伤唾液腺腺体的评估价值。方法:回顾性分析2021年8月24日至2022年1月17日就诊于山东第一医科大学第一附属医院(山东省千佛山医院)内分泌科的113例手术后接受RAI治疗的PTC患者和同期87例健康对照者,并将PTC组分为单次RAI治疗组(n=36)和多次RAI治疗组(n=77)。收集PTC组和对照组、单次RAI治疗组和多次RAI治疗组腮腺和下颌下腺二维超声和SWE的检查结果,包括左右两侧腮腺厚度、下颌下腺体积和平均剪切波速度(SWV),采用t检验比较两组之间的差异。结果:PTC组与对照组左侧下颌下腺体积分别为(7.55±0.64)cm^(3)、(8.31±0.41)cm^(3),右侧下颌下腺体积分别为(7.55±0.47)cm^(3)、(8.29±0.24)cm^(3),左侧腮腺厚度分别为(17.50±0.51)mm、(18.06±0.38)mm,右侧腮腺厚度分别为(17.48±0.52)mm、(18.08±0.33)mm。PTC组与对照组比较,左右两侧下颌下腺体积明显减小(t=9.65,13.40;均P<0.05),左右两侧腮腺厚度明显减小(t=8.57,9.40;均P<0.05)。PTC组与对照组左侧下颌下腺SWV分别为(2.23±0.22)m/s、(1.93±0.15)m/s,右侧下颌下腺SWV分别为(2.22±0.21)m/s、(1.90±0.13)m/s,左侧腮腺SWV分别为(2.21±0.23)m/s、(1.86±0.14)m/s,右侧腮腺SWV为(2.29±0.23)m/s、(1.90±0.15)m/s,PTC组左右两侧下颌下腺和腮腺的SWV明显高于对照组(t=10.91,12.49,12.52,13.72;均P<0.05)。单次RAI治疗组和多次RAI治疗组患者左右两侧腮腺厚度、下颌下腺体积、腮腺及下颌下腺的SWV,均差异无统计学意义(均P>0.05)。结论:对于RAI治疗后的患者,SWE可能是一种简单、无创的方法,可通过评估唾液腺腺体硬度来评价腮腺和下颌下腺的损伤。

Objective To evaluate the value of shear wave elasto-graphy(SWE)in salivary gland injuries after postoperative radioactive iodine(RAI)therapy for papillary thyroid carcinoma(PTC).Methods From August 24,2021,to January 17,2022,a total of 113 PTC patients who underwent RAI treatment after surgery from the Department of Endocrinology,the First Affiliated Hospital of Shandong First Medical University(Shandong Qianfoshan Hospital)and 87 healthy controls were retrospectively recruited.PTC group was divided into single RAI treatment group(n=36)and multiple RAI treatment group(n=77).Two-dimensional ultrasound and SWE examination results of parotid gland and submandibular gland were collected,including parotid gland thickness,submandibular gland volume and mean shear wave velocity(SWV)of the left and right.Student′s t-test was used to compare the differences between the 2 groups.Results The volumes of the left submandibular gland in the PTC group and the control group were(7.55±0.64)cm^(3) and(8.31±0.41)cm^(3),respectively.The volumes of the right submandibular gland were(7.55±0.47)cm^(3) and(8.29±0.24)cm^(3),respectively.The thicknesses of the left parotid gland were(17.50±0.51)mm and(18.06±0.38)mm,respectively.The thicknesses of the the right parotid gland were(17.48±0.52)mm and(18.08±0.33)mm,respectively.Compared to the control group,both the volumes of the left and right submandibular glands in the PTC group showed a significant decrease(t=9.65,13.40,all P<0.05),and the thicknesses of the left and right parotid glands also significantly decreased(t=8.57,9.40,all P<0.05).The SWV of the left submandibular gland in the PTC group and the control group were(2.23±0.22)m/s and(1.93±0.15)m/s,respectively.Similarly,the SWV of the right submandibular gland were(2.22±0.21)m/s and(1.90±0.13)m/s,respectively.The SWV of the left parotid gland were(2.21±0.23)m/s and(1.86±0.14)m/s,respectively.The SWV of right parotid gland were(2.29±0.23)m/s and(1.90±0.15)m/s,respectively.The SWV of both left and right submandibular glands and parotid glands in the PTC group were significantly higher than those in the control group(t=10.91,12.49,12.52,13.72,all P<0.05).There were no significant differences in parotid gland thickness,submandibular gland volume,SWV of parotid gland and submandibular gland between single RAI treatment group and multiple RAI treatment group(all P>0.05).Conclusion For patients after RAI treatment,SWE may be a simple,non-invasive method to evaluate parotid and submandibular gland damage by assessing salivary gland hardness.