Clinical value of contrast-enhanced ultrasound in evaluating the severity of secondary hyperparathyroidism and predicting recurrence risk after microwave ablation
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.Two-dimensional 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 severity of patients with SHPT and predicting the recurrence risk in patients with SHPT after microwave ablation,which has a certain clinical value.
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