Introduction: Secondary hyperparathyroidism (sHPT) is a prevailing complication of chronic kidney disease (CKD) caused by the disturbance of calcium, phosphate, and vitamin D, with high concentrations of serum parathormone (PTH) leading to high rates of cardiovascular and bone disease. The incidence and prevalence of chronic kidney disease, including kidney failure requiring renal replacement therapies (RRT) is rising in Europe. The objective of this study is to determine using 2D shear wave elastography, the elastographic characteristics of hyperplastic parathyroid glands in patients with chronic kidney disease and determine whether the technique adds diagnostic and localization information of these glands.
Materials and methods: We evaluated patients with stage 5 CKD under hemodialysis therapy: clinical, 2B ultrasound, Power Doppler, and shear wave elastography with computer assisted quantitative measurement of tissue elasticity with high accuracy linear probe on Supersonic Aixplorer machine.
Results: We evaluated 59 patients (male to female ratio 27:32) with mean age of 56.95 ± 10.92, mostly above 65 years old, with confirmed CKD stage 5, registered on ERSD (end-stage renal disease) program, on RRT (renal replacement therapy). A total number of 97 hyperplastic parathyroid glands were studied. Hyperplastic parathyroid glands appear as soft tissue, with a mean SWE value of 7.835 ± 2.944 kPa and minimum value of 4.630 ± 2.272 kPa and a maximum value of 12.956 ± 6126 kPa. We compared the elasticity index of hyperplastic parathyroid glands with elasticity index of thyroid tissue (mean SWE = 13.780 ± 4.039) and found significant differences.
Conclusion: The aim of this prospective study was to quantify the value of 2D Shear Wave Elastography in localizing secondary hyperparathyroidism. Elastography can be a useful tool and can better differentiatiate on tissue elasticity when localizing parathyroid hyperplasia in secondary hyperparathyroidism.
05 Sep 2020 - 09 Sep 2020