超声造影评估继发性甲状旁腺功能亢进病情严重程度及预测微波消融术后复发的临床价值  

Clinical value of contrast-enhanced ultrasound in evaluating the severity of secondary hyperparathyroidism and predicting recurrence risk after microwave ablation

作　　者：陈杰能 谢斌[1] 赵现伟[1] 张玉敏[1] 黄浩[1] CHEN Jieneng;XIE Bin;ZHAO Xianwei;ZHANG Yumin;HUANG Hao(Department of Ultrasound Medicine,Huanggang Central Hospital,Hubei 438000,China)

机构地区：[1]湖北省黄冈市中心医院超声医学科,438000

出　　处：《临床超声医学杂志》2024年第12期1032-1036,共5页Journal of Clinical Ultrasound in Medicine

摘　　要：目的应用超声造影评估继发性甲状旁腺功能亢进(SHPT)病情严重程度并预测微波消融术后复发,探讨其临床价值。方法选取在我院就诊的SHPT患者75例,依据血清全段甲状旁腺激素水平分为轻度组20例、中度组33例、重度组22例,进一步根据术后6个月甲状旁腺激素水平将患者分为复发组13例和未复发组62例,应用二维超声测量结节最大径,超声造影获取结节灌注模式、增强早晚、增强均匀性、达峰时间、到达时间、峰值强度,比较各组上述超声检查结果的差异。绘制受试者工作特征(ROC)曲线分析超声造影图像特征或参数预测SHPT患者微波消融术后复发的诊断效能。结果轻、中、重度组结节最大径、灌注模式、增强均匀性、到达时间、峰值强度比较差异均有统计学意义(均P<0.05);轻、中度组灌注模式均匀及增强均匀占比均高于重度组(均P<0.05),到达时间和峰值强度均低于重度组,差异均有统计学意义(均P<0.05);各组增强早晚、达峰时间比较差异均无统计学意义。复发组与未复发组增强均匀性和峰值强度比较差异均有统计学意义(均P<0.05)。ROC曲线分析显示,峰值强度、增强均匀性预测SHPT患者微波消融术后复发的曲线下面积分别为0.686、0.731(均P<0.05)。结论超声造影可用于评估SHPT患者病情严重程度,并可预测SHPT患者微波消融术后复发,具有一定的临床价值。Objective To evaluating the severity of secondary hyperparathyroidism(SHPT)and predicting recurrence risk after microwave ablation by contrast-enhanced ultrasound,and to explore its clinical value.Methods Totally 75 patients with SHPT in our hospital were selected,they were divided into mild group(n=20),moderate group(n=33)and severe group(n=22)according to serum whole segment parathyroid hormone level.While the patients were divided into recurrence group(n=13)and non-recurrence group(n=62)according to the parathyroid hormone level at 6 months after surgery.Twodimensional ultrasound was used to measure the maximum nodule diameter.Contrast-enhanced ultrasound was used to obtain the perfusion pattern,early and late enhancement,enhancement uniformity,arrival time,peak intensity(PI),peak time.The differences of above ultrasonographic results were compared among the groups.Receiver operating characteristics(ROC)curve was drawn to analyze the diagnostic efficiency of contrast-enhanced ultrasonic imaging features and parameters in predicting the recurrence after microwave ablation in patients with SHPT.Results There were statistically significant differences in maximum nodule diameter,perfusion pattern,enhancement uniformity,arrival time and PI among mild,moderate and severe groups(all P<0.05).The proportions of perfusion pattern and enhancement uniformity in mild and moderate groups were higher than those in severe group(all P<0.05),while the arrival time and PI were lower than those in severe group(all P<0.05).There were no statistical differences in early and late enhancement and peak time among groups.There were statistical differences in the proportion of enhancement uniformity and PI between recurrence group and non-recurrence group(both P<0.05).ROC curve analysis showed that the areas under the curve of PI and enhancement uniformity in predicting recurrence in patients with SHPT after microwave ablation were 0.686,0.731(both P<0.05),respectively.Conclusion Contrast-enhanced ultrasound can be used to evaluate the

关 键 词：超声检查 造影剂 甲状旁腺功能亢进 继发性 术后复发 预测 

分 类 号：R445.1[医药卫生—影像医学与核医学] R736.1[医药卫生—诊断学]