scholarly journals Shear Wave Elastography in Patients with Primary and Secondary Hyperparathyroidism

2021 ◽  
Vol 10 (4) ◽  
pp. 697
Author(s):  
Daniela Amzar ◽  
Laura Cotoi ◽  
Ioan Sporea ◽  
Bogdan Timar ◽  
Oana Schiller ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Secondary Hyperparathyroidism ◽  
Shear Wave ◽  
Muscle Tissue ◽  
Parathyroid Tissue ◽  
Shear Wave Elastography ◽  
The Other ◽  
Cutoff Value ◽  
Helpful Tool ◽  
Parathyroid Adenomas

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.

scholarly journals Parathyroid Elastography―Elastography Evaluation Algorithm

2020 ◽  
Vol 2020 (1) ◽  
pp. 1
Author(s):  
Laura Cotoi ◽  
Daniela Amzăr ◽  
Ioan Sporea ◽  
Andreea Borlea ◽  
Oana Schiller ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Secondary Hyperparathyroidism ◽  
Muscle Tissue ◽  
Thyroid Tissue ◽  
Parathyroid Tissue ◽  
Parathyroid Glands ◽  
Cervical Lymph Nodes ◽  
Cardiovascular Morbidity And Mortality ◽  
Parathyroid Lesions ◽  
Parathyroid Disease

(1) Background: Primary hyperparathyroidism is a common disorder of the parathyroid glands and the third most frequent endocrinopathy, especially among elderly women. Secondary hyperparathyroidism is a common complication of chronic kidney disease, associated with high cardiovascular morbidity and mortality. In both primary and secondary hyperparathyroidism, the need to correctly identify the parathyroid glands is mandatory for a better outcome. Elastography can be an effective tool in the diagnosis of parathyroid lesions, by differentiating possible parathyroid lesions from thyroid disease, cervical lymph nodes, and other anatomical structures. There are currently no guidelines or recommendations and no established values on the elasticity of parathyroid lesions. (2) Material and Methods: In our studies, we have evaluated, by Shear Wave elastography (SWE), both primary and secondary hyperparathyroidism, determining that parathyroid glands have a higher elasticity index than both thyroid tissue and muscle tissue. (3) Results: For primary hyperparathyroidism, we have determined, using 2D-SWE, the parathyroid adenoma tissue (mean elasticity index (EI) measured by SWE 4.74 ± 2.74 kPa) with the thyroid tissue (11.718 ± 4.206 kPa) and with the surrounding muscle tissue (16.362 ± 3.829 kPa). For secondary hyperparathyroidism, by SWE elastographic evaluation, we have found that the mean EI in the parathyroid gland was 7.83 kPa, a median value in the thyroid parenchyma of 13.76 kPa, and a mean muscle EI value at 15.78 kPa. (4) Conclusions: Elastography can be a useful tool in localizing parathyroid disease, whether primary or secondary, by correctly identifying the parathyroid tissue. We have determined that an EI below 7 kPa in SWE elastography correctly identifies parathyroid tissue in primary hyperparathyroidism, and that a cut-off value of 9.98 kPa can be used in 2D-SWE to accurately diagnose parathyroid disease in secondary hyperparathyroidism.

scholarly journals Shear Wave Elastography versus Strain Elastography in Diagnosing Parathyroid Adenomas

2020 ◽  
Vol 2020 ◽  
pp. 1-11 ◽  
Author(s):  
Laura Cotoi ◽  
Daniela Amzar ◽  
Ioan Sporea ◽  
Andreea Borlea ◽  
Dan Navolan ◽  
...  
Keyword(s):  
Parathyroid Adenoma ◽  
Shear Wave ◽  
Muscle Tissue ◽  
Thyroid Tissue ◽  
Shear Wave Elastography ◽  
Strain Ratio ◽  
Strain Elastography ◽  
Parathyroid Adenomas ◽  
The Mean ◽  
Thyroid Parenchyma

Objectives. The aim of the study was to compare elastographic means in parathyroid adenomas, using shear wave elastography and strain elastography. Methods. This prospective study examined 20 consecutive patients diagnosed with primary hyperparathyroidism and parathyroid adenoma, confirmed by biochemical assay, technetium-99 sestamibi scintigraphy, and pathology report, after parathyroid surgery. All patients were examined on conventional 2B ultrasound, 2D shear wave elastography, and strain elastography. We determined using 2D shear wave elastography (SWE) the elasticity index (EI) in parathyroid adenoma, thyroid parenchyma, and surrounding muscle and examined using strain elastography the parathyroid adenoma, and determined the strain ratio with the thyroid tissue and muscle tissue. Results. All patients had positive sestamibi scintigraphy and underwent surgery, with confirmation of parathyroid adenoma in all cases. The mean parathormone (PTH) value before surgery was 153.29 pg/ml (36.5, 464.8) and serum calcium concentration was 10.5 mg/dl (9, 11.5). We compared using 2D-SWE and strain elastography parathyroid adenoma with thyroid tissue and with surrounding muscle. The mean EI measured by SWE in parathyroid adenoma was 4.74 ± 2.74 kPa and in thyroid parenchyma was 11.718 ± 4.206 kPa (mean difference = 6.978 kPa, p<0.001), and the mean EI value in muscle tissue was 16.362 ± 3.829 kPa (mean difference = 11.622, p<0.001). Using ROC analysis, we found that an EI below 7 kPa correctly identifies parathyroid tissue. We evaluated parathyroid adenomas using strain elastography by color mapping and strain ratio as a semiquantitative measurement; however, we could not find any statistical correlation comparing the strain ratio obtained from the parathyroid adenoma with the thyroid tissue (p=0.485). Conclusion. Ultrasound elastography is a helpful tool in identifying parathyroid adenomas. A cutoff value below 7 kPa can be used in 2D-SWE. Color maps in strain elastography without adding strain ratio can be used, parathyroid adenoma being identified as score 1 in the Rago criteria.

Diagnotic value of Shear Wave Elastography in differentiating parathyroid adenomas from thyroid nodules

2019 ◽  
Author(s):  
Mihaela Vlad ◽  
Ioana Golu ◽  
Maria Oprea ◽  
Daniela Amzar ◽  
Melania Balas ◽  
...  
Keyword(s):  
Shear Wave ◽  
Thyroid Nodules ◽  
Shear Wave Elastography ◽  
Parathyroid Adenomas

scholarly journals Liver ultrasound elastography for the evaluation of periportal fibrosis in schistosomiasis mansoni: A cross-sectional study

2018 ◽  
Author(s):  
Joelma Carvalho Santos ◽  
Andrea Dória Batista ◽  
Carla Maria Mola Vasconcelos ◽  
Roberto Souza Lemos ◽  
Valter Romão de Souza ◽  
...  
Keyword(s):  
Shear Wave ◽  
Shear Wave Elastography ◽  
Cross Sectional Study ◽  
Cutoff Point ◽  
Sectional Study ◽  
Cross Sectional ◽  
Predictive Values ◽  
Cutoff Value ◽  
Periportal Fibrosis ◽  
Schistosomiasis Mansoni

AbstractBackgroundARFI elastrography has been used as a noninvasive method to assess the severity of liver fibrosis in viral hepatitis, although with few studies in schistosomiasis mansoni. We aimed to evaluate the performance of point shear wave elastography (pSWE) for predicting significant periportal fibrosis (PPF) in schistosomotic patients and to determine its best cutoff point.Methodology/Principal findingsThis cross-sectional study included 358 adult schistosomotic patients subjected to US and pSWE on the right lobe. Two hundred two patients (62.0%) were women, with a median age of 54 (ranging 18-92) years. The pSWE measurements were compared to the US patterns of PPF, as gold standard, according to the Niamey classification. The performance of pSWE was calculated as the area under the ROC curve (AUC). Patients were further classified into two groups: 86 patients with mild PPF and 272 patients with significant PPF. The median pSWE of the significant fibrosis group was higher (1.40 m/s) than that of mild fibrosis group (1.14 m/s, p<0.001). AUC was 0.719 with ≤1.11 m/s as the best cutoff value for excluding significant PPF. Sensitivity and negative predictive values were 80.5% and 40.5%, respectively. Whereas, for confirming significant PPF, the best cutoff value was >1.39 m/s, with specificity of 86.1% and positive predictive value of 92.0%.Conclusions/SignificancepSWE was able to differentiate significant from mild PPF, with better performance to predict significant PPF.Author summaryIn the developing world, over 207 million people are infected with parasitic Schistosoma worms. Among the species of Schistosoma that infect humans Schistosoma mansoni is one of the most common causes of illness. Here, we investigated the performance of point shear wave elastography (pSWE) for predicting significant periportal fibrosis (PPF) in schistosomotic patients and to determine its best cutoff point. We examined 358 people from northeast of Brazil for Schistosoma infections. The present study showed that pSWE was able to differentiate significant from mild PPF, with better performance to predict significant PPF.

scholarly journals Comparison between shear wave elastography and serological findings for the evaluation of fibrosis in chronic liver disease

2021 ◽  
Vol 21 (86) ◽  
pp. e186-e193
Author(s):  
Mahjabeen Liaqat ◽  
◽  
Kashif Siddique ◽  
Imran Yousaf ◽  
Raham Bacha ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Fibrosis ◽  
Diagnostic Accuracy ◽  
Chronic Liver Disease ◽  
Shear Wave ◽  
Shear Wave Elastography ◽  
Chronic Liver ◽  
Optimal Cutoff ◽  
Cutoff Value ◽  
Cutoff Values

Aim: In this study, we sought to examine the optimal cutoff values for predicting different stages of liver fibrosis, and to determine the level of agreement between shear wave elastography and aspartate aminotransferase to platelet ratio index (APRI) and fibrosis-4 index (FIB-4) scores in patients with chronic liver disease. Methodology: A descriptive, cross-sectional study was performed at the Radiology Department of Shaukat Khanum Memorial Hospital Lahore from 1 Jun 2019 until 1 June 2020. FIB-4 and APRI scores were determined by the following formula: FIB-4 = (age × AST) ÷ (platelet count × (√ (ALT)) and APRI = (AST÷AST upper limit of normal) ÷ platelet × 100. Data was analyzed with the help of SPSS version 24.0 and Microsoft Excel 2013. Results: Eighty individuals were conveniently selected, of which 62.5% were men and 37.5% were women. The mean age of the subjects was 43.47 SD ± 13.85 years. APRI and FIB-4 scores predicted F4 patients using the cutoff values of 0.47 (Sn. 72%, Sp. 70%) and 1.27 (Sn. 78%, Sp. 73%), respectively. The cutoff values of 0.46 for APRI and 1.27 for FIB-4 predicted F3–F4 patients (Sn. 74% and 77%; Sp. 76% and 76%), respectively. To predict F1–F4 compared to F0, the cutoff value was 0.34 (Sn. 68%, Sp. 75%) for APRI, while the cutoff value for FIB was 0.87 (Sn. 72%, Sp. 75%). The findings suggest that FIB-4 shows better diagnostic accuracy than APRI. Conclusion: This study provides optimal cutoff values for different groups of fibrosis patients for both serum markers. Also, the diagnostic accuracy of FIB-4 for predicting liver fibrosis was found to be superior to APRI in all disease stages.

Shear wave elastography for characterizing muscle tissue in myofascial pain syndrome

2013 ◽  
Vol 133 (5) ◽  
pp. 3358-3358
Author(s):  
Diego Turo ◽  
Paul Otto ◽  
Tadesse Gebreab ◽  
Katherine Armstrong ◽  
Lynn H. Gerber ◽  
...  
Keyword(s):  
Shear Wave ◽  
Muscle Tissue ◽  
Myofascial Pain ◽  
Pain Syndrome ◽  
Shear Wave Elastography ◽  
Myofascial Pain Syndrome

PRE-OPERATIVE LOCALIZATION OF HYPERFUNCTIONING PARATHYROID TISSUE BY PARATHYROID SCINTIGRAPHY

1976 ◽  
Vol 81 (2) ◽  
pp. 298-309 ◽  
Author(s):  
P. Burckhardt ◽  
A. Bischof-Delaloye ◽  
B. Ruedi ◽  
B. Delaloye
Keyword(s):  
Primary Hyperparathyroidism ◽  
False Positive ◽  
Parathyroid Tissue ◽  
Tubular Reabsorption ◽  
Plasma Calcium ◽  
Parathyroid Scintigraphy ◽  
Biochemical Screening ◽  
Parathyroid Adenomas ◽  
Positive Results ◽  
Positive Focus

ABSTRACT In 22 patients who underwent surgery suspected of primary hyperparathyroidism, the surgical findings were compared with the results obtained by pre-operative parathyroid scanning and biochemical screening. Thirteen of 15 parathyroid adenomas were localized by pre-operative scanning, but in five of them a false positive focus was also described. The technique was less useful in primary hyperplasia. Comparable results were reported by other investigators. In both instances the best results were obtained in patients with high parathyroid activity as measured by plasma calcium, plasma alkaline phosphatase and tubular reabsorption of phosphorus (TRP). Parathyroid scintigraphy was especially helpful in the presence of ectopic adenomas and in patients who had undergone previous parathyroid surgery. Unfortunately, the possibility of false positive results makes it unreliable for the diagnosis of primary hyperparathyroidism.

Evaluation of healthy muscle tissue by strain and shear wave elastography – Dependency on depth and ROI position in relation to underlying bone

Ultrasonics ◽  
2016 ◽  
Vol 71 ◽  
pp. 127-133 ◽  
Author(s):  
Caroline Ewertsen ◽  
Jonathan Frederik Carlsen ◽  
Iben Riishede Christiansen ◽  
Jørgen Arendt Jensen ◽  
Michael Bachmann Nielsen
Keyword(s):  
Shear Wave ◽  
Muscle Tissue ◽  
Shear Wave Elastography

scholarly journals Shear-wave elastography in diagnostics of primary hyperparathyroidism - new application of the method

2015 ◽  
Author(s):  
Adam Stangierski ◽  
Kosma Wolinski ◽  
Ewelina Szczepanek-Parulska ◽  
Marek Ruchala
Keyword(s):  
Primary Hyperparathyroidism ◽  
Shear Wave ◽  
Shear Wave Elastography

scholarly journals The Usefulness of Noninvasive Liver Stiffness Assessment Using Shear-Wave Elastography for Predicting Liver Fibrosis in Children

2020 ◽  
Author(s):  
Seunghyun Lee ◽  
Young Hun Choi ◽  
Yeon Jin Cho ◽  
Seul Bi Lee ◽  
Jung-Eun Cheon ◽  
...  
Keyword(s):  
Liver Disease ◽  
Shear Wave ◽  
Diagnostic Performance ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Fibrosis Stage ◽  
Receiver Operating Curve ◽  
Affecting Factors ◽  
Cutoff Value ◽  
Factors Affecting

Abstract Background: Pediatric patients with liver disease require noninvasive monitoring for the likelihood of fibrosis progression. The purpose of this study is to evaluate the significant factors affecting liver stiffness values from two-dimensional-shear wave elastography (2D-SWE), and whether liver stiffness can predict the fibrosis stage of various childhood liver diseases.Methods: This study comprised 30 children (22 boys and 8 girls; mean age, 5.1 ± 6.1 years; range, 7 days–17.9 years) who had undergone biochemical evaluation, 2D-SWE examination, and histopathologic analysis with fibrosis grade (F0 to F3), necroinflammatory activity, and steatosis grade between August 2016 and March 2020. The liver stiffness from 2D-SWE were compared between fibrosis stages using the Kruskal-Wallis analysis. The significant affecting factors to liver stiffness were evaluated using univariate and multivariate linear regression analyses. The diagnostic performance was determined from the area under the receiver operating curve (AUC) values of the 2D-SWE liver stiffness.Results: Liver stiffness at the F0-1, F2, and F3 stages were 7.9, 13.2, and 21.7 kPa (P < 0.001). Both of fibrosis stage and necroinflammatory grade were factors significantly associated with liver stiffness (P < 0.001 and P = 0.021). Liver stiffness value could distinguish significant fibrosis (≥F2) with an AUC of 0.950 (cutoff value, 11.3 kPa) and the severe fibrosis (F3 stage) with an AUC of 0.924 (cutoff value, 18.1 kPa). Conclusion: The liver stiffness values from 2D-SWE can be effected through both fibrosis and necroinflammatory grade and can provide excellent diagnostic performance in evaluating the fibrosis stage, even in various liver disease.

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