【摘要】：目的:使用聲觸診組織量化剪切波彈性成像技術(shù)(virtual touch tissue imaging quantification,VTIQ)測量維持性血液透析患者甲狀旁腺組織剪切波速度(shear wave velocity,SWV)。旨在探討VTIQ在繼發(fā)性甲狀旁腺功能亢進(jìn)(secondary hyperparathyroidism,SHPT)中的應(yīng)用價(jià)值。方法:研究組107例選自青島大學(xué)附屬醫(yī)院血液透析中心慢性腎臟病(chronic kidney disease,CKD)5期血透患者,根據(jù)甲狀旁腺激素(intact parathyroid hormone,i PTH)測量值將其分為3組:A組(㩳300pg/ml)、B組(300pg/ml~800pg/ml)、C組(≥800pg/ml)。正常對照組30例選自青島大學(xué)附屬醫(yī)院腎病科自愿接受甲狀旁腺超聲及VTIQ檢查醫(yī)護(hù)人員。應(yīng)用常規(guī)超聲檢查甲狀旁腺,描述其二維超聲圖像特征。隨后啟用VTIQ技術(shù)測量組織的SWV,通過組間比較、相關(guān)性檢驗(yàn)分析不同組間SWV差異及變化特征,繪制受試者工作特征曲線(receiver operator characteristic curve,ROC曲線)并尋找最佳診斷閾值。結(jié)果:通過比較組間SWV值發(fā)現(xiàn),A組(2.081±0.463)m/s與正常對照組(1.978±0.303)m/s差異無統(tǒng)計(jì)學(xué)意義(P=0.430),B組(2.428±0.502)m/s、C組(3.022±0.707)m/s SWV均較正常對照組增大(P=0.001、0.000),A、B組,B、C組,A、C組SWV組間差異有統(tǒng)計(jì)學(xué)意義(P=0.005、0.000、0.000)。i PTH與SWV之間呈正相關(guān)(r=0.680,P=0.000)。以i PTH值300pg/ml和800pg/ml分別作為診斷SHPT及手術(shù)的截?cái)帱c(diǎn),對SWV進(jìn)行ROC分析發(fā)現(xiàn)其曲線下面積分別為0.798、0.842(均P=0.000),截?cái)嘀禐?.260m/s、2.720m/s,敏感度分別為79.17%、80.00%,特異度分別為77.14%、83.33%。結(jié)論:VTIQ技術(shù)可無創(chuàng)定量評估繼發(fā)性甲狀旁腺功能亢進(jìn)患者的甲狀旁腺彈性變化。剪切波速度值2.260m/s和2.720m/s可以分別作為診斷SHPT及手術(shù)治療的參考點(diǎn),為評估甲狀旁腺功能提供有利的診斷依據(jù),進(jìn)而做出不同臨床干預(yù)具有廣闊應(yīng)用前景。
[Abstract]:Objective: to measure the shear wave velocity (shear wave velocity,SWV) of parathyroid gland in maintenance hemodialysis patients by acoustic palpation tissue quantitative shear wave elastography (virtual touch tissue imaging quantification,VTIQ). To explore the application value of VTIQ in secondary hyperparathyroidism (secondary hyperparathyroidism,SHPT). Methods: 107 patients with chronic kidney disease (chronic kidney disease,CKD) from hemodialysis center of Qingdao University affiliated Hospital were divided into three groups according to the measured value of parathyroid hormone (intact parathyroid hormone,i PTH): group A (? 300pg/ml), B group) (300pg/ml~800pg/ml), C group (鈮，

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