The Value Of Shear Wave Elastography In The Differential Diagnosis Of Parathyroid Adenoma And Parathyroid Hyperplasia

Objective To explore the application value of shear wave elastography in the differential diagnosis of parathyroid adenoma and parathyroid hyperplasia.Methods From August 2018 to December 2019,40 patients with clinically diagnosed hyperparathyroidism in the Affiliated Hospital of Inner Mongolia Medical University and undergoing surgical treatment in nail and breast surgery were selected,with a total of 52 diseased parathyroid glands.The SWE technique was used to measure the elastic Young's modulus(EI)of the parathyroid glands before surgery.Using pathology as the gold standard,they were divided into adenoma group and hyperplasia group.The EI values of two groups were statistically analyzed,the optimal cutoff value for differential diagnosis of parathyroid adenoma and hyperplastic elasticity EI-Mean was deter mined by plotting the receiver operating characteristic curve ROC.Results(1)The EI-Mean and EI-Max values of parathyroid adenoma are higher than those of parathyroid hyperplasia,the difference is statistically significant(P <0.05),and the EI-Min value of the two groups is not statistically significant(P> 0.05).(2)Construct the ROC curve and determine the optimal threshold for EI-Mean for the differential diagnosis of parathyroid adenoma and hyperplasia is 11.6k Pa.The sensitivity of the diagnosis of adenoma is 80.95%,the specificity is 83.87%,and the accuracy rate is 82.69%.The AUC was 0.896.The optimal threshold for the differential diagnosis of EI-Max was 23.4k Pa.The sensitivity of the diagnosis of parathyroid a denoma was 66.67%,the specificity was 70.97%,the accuracy was 69.23%,and the AUC was 0.711.(3)The sensitivity,specificity,and accuracy of EI-Mean for the differential diagnosis of thyroid adenoma and hyperplasia were higher than those of EI-Max,and the difference between the two pairs was statistically significant(P <0.05).The AUC curve diagnosed by EI-Mean was larger than EI-Max,and the difference was statistically significant(Z = 2.289,P= 0.0221).Conclusions(1)SWE can more accurately and objectively reflect the hardness of parathyroid lesions,which is helpful for the differential diagnosis of parathyroid adenomas and hyperplasia.(2)The hardness of parathyroid adenoma is higher than that of parathyroid hyper plasia.Using EI-Mean = 11.6KPa as the optimal cutoff value,preoperative differential diagnosis of parathyroid adenoma and hyperplasia can be performed,and its diagnostic efficiency is high.At EI-Max.SWE can complement conventional ultrasound to improve the differential diagnosis of parathyroid disease.