Abstract
Objectives: In this study, we aim to determine the elastographic characteristics of both primary and secondary hyperparathyroidism using shear wave elastography. We also aim to evaluate the elastographic differences between them, as well as the differences between the parathyroid, thyroid, and muscle tissue, in order to better identify a cutoff value for the parathyroid tissue. Methods: In this prospective study, we examined a total of 68 patients with hyperparathyroidism, divided into two groups; one group consisted of 27 patients with primary hyperparathyroidism and the other group consisted of 41 selected patients with confirmed secondary hyperparathyroidism. The elasticity index (EI) was determined in the parathyroid, thyroid, and muscle tissue. The determined values were compared to better identify the parathyroid tissue. Results: The median value of mean SWE values measured for parathyroid adenomas from primary hyperparathyroidism was 4.86 kPa. For secondary hyperparathyroidism, the median value of mean SWE was 6.96 KPa. The median (range) presurgical values for parathormone (PTH) and calcium were 762.80 pg/mL (190, 1243) and 9.40 mg/dL (8.825, 10.20), respectively. We identified significant elastographic differences between the two groups (p < 0.001), which remained significant after adjusting elastographic measures to the nonparametric parameters, such as the parathormone value and vitamin D (p < 0.001). The cutoff values found for parathyroid adenoma were 5.96 kPa and for parathyroid tissue 9.58 kPa. Conclusions: Shear wave elastography is a helpful tool for identifying the parathyroid tissue, in both cases of primary and secondary hyperparathyroidism, as there are significant differences between the parathyroid, thyroid, and muscle tissue. We found a global cutoff value for the parathyroid tissue of 9.58 kPa, but we must keep in mind that there are significant elastographic differences between cutoffs for primary and secondary hyperparathyroidism.
Highlights
Recent advancements in medical technologies have improved diagnostic methods, increasing the incidence of certain endocrine diseases [1,2]
We evaluated a total of 68 patients, divided into two lots, one of 27 patients with primary hyperparathyroidism and the other lot consisting of 41 patients with secondary renal hyperparathyroidism
The results were structured into two parts; in the first part of the results section, we evaluated the elastographic results by dividing them into two subgroups—the first group of primary hyperparathyroidism and the second group of secondary hyperparathyroidism—
Summary
Recent advancements in medical technologies have improved diagnostic methods, increasing the incidence of certain endocrine diseases [1,2]. Hyperparathyroidism is a common endocrine disorder, as primary hyperparathyroidism is the third endocrinopathy after type 2 diabetes mellitus and thyroid disease [3], parathyroid adenoma being cited as the most common cause of primary hyperparathyroidism. Other rare causes such as multiglandular disease and parathyroid carcinoma are cited [4,5,6]. The high prevalence is seen among postmenopausal women (female–male ratio 3–4:1) [1,12,13,14], emphasizing the fact that incidence increased because of active screening, as shown by a study conducted by Palmer et al in Sweden [15]
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