The Value of the Model and Quantitative Parameters of Contrast-Enhanced Ultrasound in Judging the Severity of SHPT

Abstract

Using the model and quantitative parameters of contrast-enhanced ultrasound (CEUS) to assess the severity of secondary hyperparathyroidism (SHPT) was proposed. 42 SHPT patients who underwent CEUS examination were divided into three groups, light, moderate, and heavy as per parathyroid hormone (PTH). The process of CEUS was divided into two phases, wash-in phase and wash-out phase. The three groups were analyzed with their enhancing model in the two phases. The quantitative parameters of CEUS such as Arrival Time (AT), Time to Peak (TTP), Mean Transit Time (MTT), and Maximum Intensity (IMAX) were measured by time-intensity curve (TIC) and compared among the three groups. The enhancing model of light SHPT, moderate SHPT, and heavy SHPT showed statistical significance in wash-in phase and wash-out phase (P < 0.05). No difference was observed in AT and TTP among the three groups (P > 0.05) while MTT and IMAX showed statistical significance (P < 0.05). The CEUS of light SHPT was characterized by “slow-in, fast-out, and lower-enhancement” with short enhancement time; the CEUS of moderate SHPT was characterized by “fast-in, fast-out, and higher-enhancement” with slightly long enhancement time; the CEUS of heavy SHPT was characterized by “fast-in, slow-out, and higher-enhancement” with long enhancement time. Therefore, the model and quantitative parameters of CEUS can be benefit for the assessment of the severity of SHPT.

A roadmap to parathyroidectomy for kidney transplant candidates

“…Conventional ultrasound has low sensitivity in assessing the severity of SHPT because it cannot display the dynamic perfusion characteristics. CEUS could address this deficiency and detect nodular hyperplasic parathyroid glands before SHPT becomes resistant to medical therapy through time–intensity curves that illustrate the dynamic features of tissue vascularization and blood flow (wash-in time, intensity and wash-out time) [ 124 ] (Figure 6D ).…”

Diagnostic performance of ultrasonography, dual-phase 99mTc-MIBI scintigraphy, early and delayed 99mTc-MIBI SPECT/CT in preoperative parathyroid gland localization in secondary hyperparathyroidism

“…In our study, all patients had increased serum PTH, but only 23.33% of patients showed increased serum calcium. We found that 23 patients showed punctate and annular calcification in the hyperplastic parathyroid glands, and annular calcification might be a special sign of SHPT [ 28 – 30 ]. Soft tissue and vascular calcification is commonly present in end-stage renal disease, secondary to disturbances in the calcium and phosphate balance and HPT, which may explain why the parathyroid glands were more prone to calcification in patients with SHPT [ 31 , 32 ].…”

Diagnostic performance of ultrasonography, dual-phase 99mTc-MIBI scintigraphy, early and delayed 99mTc-MIBI SPECT/CT in preoperative parathyroid gland localization in secondary hyperparathyroidism

“…In our study, all patients had increased serum PTH, but only 23.33% of patients showed increased serum calcium. We found that 23 patients showed punctate and annular calci cation in the hyperplastic parathyroid glands, and annular calci cation might be a special sign of SHPT [28][29][30]. Soft tissue and vascular calci cation is commonly present in end-stage renal disease, secondary to disturbances in the calcium and phosphate balance and HPT, which may explain why the parathyroid glands were more prone to calci cation in patients with SHPT [31,32].…”