The Application Value Of Elastic Imaging Strain Ratio Method In The Differential Diagnosis Of Parathyroid Gland Hyperplasia And Adenoma

Objective:To explore the value of elastography strain rate ratio method in the differential diagnosis of parathyroid hyperplasia and adenoma.Methods:A total of 45 parathyroid patients(56 lesions)were selected from our hospital for thyroid surgery between February 2016 and February 2018.Ultrasound Elastography(UE)examinations were performed before parathyroid surgery.Echo-elasticity images were obtained.Elasticity scoring was used to score the lesioned parathyroid glands.To determine the strain rate ratio(SR)of lesioned parathyroid tissue and normal thyroid tissue on the same side.Using postoperative pathological results as the gold standard,they were divided into hyperplasia group(33)and adenoma group(23),to determine the best critical value for the identification of parathyroid hyperplasia and adenoma SR by plotting the characteristics of the subject’s work.Results:1 The median SR of the parathyroid hyperplasia group was 0.99(0.79,1.50),and the median SR of the adenoma group was 2.07(1.43,2.20).The difference was statistically significant(Z=-3.97,P<0.05).2 The ROC curve determined that the optimal diagnostic critical point for SR in differential hyperplasia and adenoma was 1.85,with a sensitivity of 73.9 %,a specificity of 84.8%,and an accuracy of 80.3%.3 The area under the ROC curve of the ratio of strain rate to parathyroid hyperplasia and adenoma was 0.814,and the area under the ROC curve was 0.798.There was no significant difference between the two groups(Z=0.01,P>0.05).4 Comparison of the strain rate ratio method and scoring method to identify the sensitivity of parathyroid hyperplasia,adenoma(73.9 %/69.6 %),specificity(84.8%/81.8%),accuracy(80.3%/76.8%),two or two There was no significant difference between the two groups(P>0.05).Conclutions:1 Parathyroid adenoma SR is higher than parathyroid hyperplasia,SR=1.85 as the best diagnostic threshold can be used for differential diagnosis of parathyroid hyperplasia and adenoma before surgery,providing the basis for the choice of clinical treatment options.2 The elastography scoring method and the strain rate ratio method can be used to differentiate between parathyroid hyperplasia and adenoma,but the strain rate ratio method is more objective than a scoring method as a semi-quantitative method.