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中华诊断学电子杂志 ›› 2024, Vol. 12 ›› Issue (02) : 80 -84. doi: 10.3877/cma.j.issn.2095-655X.2024.02.002

临床研究

剪切波弹性成像对甲状腺癌术后放射性碘治疗损伤唾液腺腺体的评估
刘通1, 李菲2, 朱莹3, 王蓓2,†()   
  1. 1. 272067　济宁医学院临床医学院
    2. 250014　济南，山东省医药卫生腹部医学影像学重点科室，山东第一医科大学第一附属医院（山东省千佛山医院超声诊疗科）
    3. 250014　济南，山东省妇幼保健院超声科
  • 收稿日期:2024-01-03 出版日期:2024-05-26
  • 通信作者: 王蓓

Evaluation of shear wave elasto-graphy for salivary gland injury induced by radioiodine iodine after thyroid cancer surgery

Tong Liu1, Fei Li2, Ying Zhu3, Bei Wang2,†()   

  1. 1. College of Clinical Medicine, Jining Medical University, Jining 272067, China
    2. Key Department of Abdominal Medicine Imaging of Shandong Province, the First Affiliated Hospital of Shandong First Medical University (Shandong Provincial Qianfoshan Hospital), Jinan 250014, China
    3. Department of Ultrasound, Shandong Maternal and Child Health Hospital, Jinan 250014, China
  • Received:2024-01-03 Published:2024-05-26
  • Corresponding author: Bei Wang
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引用本文：

刘通, 李菲, 朱莹, 王蓓. 剪切波弹性成像对甲状腺癌术后放射性碘治疗损伤唾液腺腺体的评估[J]. 中华诊断学电子杂志, 2024, 12(02): 80-84.

Tong Liu, Fei Li, Ying Zhu, Bei Wang. Evaluation of shear wave elasto-graphy for salivary gland injury induced by radioiodine iodine after thyroid cancer surgery[J]. Chinese Journal of Diagnostics(Electronic Edition), 2024, 12(02): 80-84.

目的

探讨剪切波弹性成像(SWE)对甲状腺乳头状癌(PTC)术后放射性碘(RAI)治疗损伤唾液腺腺体的评估价值。

方法

回顾性分析2021年8月24日至2022年1月17日就诊于山东第一医科大学第一附属医院(山东省千佛山医院)内分泌科的113例手术后接受RAI治疗的PTC患者和同期87例健康对照者，并将PTC组分为单次RAI治疗组(n＝36)和多次RAI治疗组(n＝77)。收集PTC组和对照组、单次RAI治疗组和多次RAI治疗组腮腺和下颌下腺二维超声和SWE的检查结果，包括左右两侧腮腺厚度、下颌下腺体积和平均剪切波速度(SWV)，采用t检验比较两组之间的差异。

结果

PTC组与对照组左侧下颌下腺体积分别为(7.55±0.64)cm3、(8.31±0.41)cm3，右侧下颌下腺体积分别为(7.55±0.47)cm3、(8.29±0.24)cm3，左侧腮腺厚度分别为(17.50±0.51)mm、(18.06±0.38)mm，右侧腮腺厚度分别为(17.48±0.52)mm、(18.08±0.33)mm。PTC组与对照组比较，左右两侧下颌下腺体积明显减小(t＝9.65，13.40；均P<0.05)，左右两侧腮腺厚度明显减小(t＝8.57，9.40；均P<0.05)。PTC组与对照组左侧下颌下腺SWV分别为(2.23±0.22)m/s、(1.93±0.15)m/s，右侧下颌下腺SWV分别为(2.22±0.21)m/s、(1.90±0.13)m/s，左侧腮腺SWV分别为(2.21±0.23)m/s、(1.86±0.14)m/s，右侧腮腺SWV为(2.29±0.23)m/s、(1.90±0.15)m/s，PTC组左右两侧下颌下腺和腮腺的SWV明显高于对照组(t＝10.91，12.49，12.52，13.72；均P<0.05)。单次RAI治疗组和多次RAI治疗组患者左右两侧腮腺厚度、下颌下腺体积、腮腺及下颌下腺的SWV，均差异无统计学意义(均P>0.05)。

结论

对于RAI治疗后的患者，SWE可能是一种简单、无创的方法，可通过评估唾液腺腺体硬度来评价腮腺和下颌下腺的损伤。

关键词: 甲状腺肿瘤，乳头状, 超声检查, 放射性碘, 唾液腺, 剪切波弹性成像
Objective

To evaluate the value of shear wave elasto-graphy (SWE) in salivary gland injuries after postoperative radioactive iodine (RAI) therapy for papillary thyroid carcinoma (PTC).

Methods

From August 24, 2021, to January 17, 2022, a total of 113 PTC patients who underwent RAI treatment after surgery from the Department of Endocrinology, the First Affiliated Hospital of Shandong First Medical University (Shandong Qianfoshan Hospital) and 87 healthy controls were retrospectively recruited. PTC group was divided into single RAI treatment group (n=36) and multiple RAI treatment group (n=77). Two-dimensional ultrasound and SWE examination results of parotid gland and submandibular gland were collected, including parotid gland thickness, submandibular gland volume and mean shear wave velocity (SWV) of the left and right. Student′s t-test was used to compare the differences between the 2 groups.

Results

The volumes of the left submandibular gland in the PTC group and the control group were (7.55±0.64)cm3 and (8.31±0.41)cm3, respectively. The volumes of the right submandibular gland were (7.55±0.47)cm3 and (8.29±0.24)cm3, respectively. The thicknesses of the left parotid gland were (17.50±0.51)mm and (18.06±0.38)mm, respectively. The thicknesses of the the right parotid gland were (17.48±0.52)mm and (18.08±0.33)mm, respectively. Compared to the control group, both the volumes of the left and right submandibular glands in the PTC group showed a significant decrease (t=9.65, 13.40, all P<0.05), and the thicknesses of the left and right parotid glands also significantly decreased (t=8.57, 9.40, all P<0.05). The SWV of the left submandibular gland in the PTC group and the control group were (2.23±0.22)m/s and (1.93±0.15)m/s, respectively.Similarly, the SWV of the right submandibular gland were (2.22±0.21)m/s and (1.90±0.13)m/s, respectively. The SWV of the left parotid gland were (2.21±0.23)m/s and (1.86±0.14)m/s, respectively. The SWV of right parotid gland were (2.29±0.23)m/s and (1.90±0.15)m/s, respectively.The SWV of both left and right submandibular glands and parotid glands in the PTC group were significantly higher than those in the control group (t=10.91, 12.49, 12.52, 13.72, all P<0.05). There were no significant differences in parotid gland thickness, submandibular gland volume, SWV of parotid gland and submandibular gland between single RAI treatment group and multiple RAI treatment group (all P>0.05).

Conclusion

For patients after RAI treatment, SWE may be a simple, non-invasive method to evaluate parotid and submandibular gland damage by assessing salivary gland hardness.

Key words: Thyroid neoplasms, papillary, Ultrasonography, Radioactive iodine, Salivary gland, Shear wave elasto-graphy
图1 甲状腺乳头状癌患者腮腺SWE检查图像注：男性患者65岁，剪切波速度测量值为2.25 m/s；SWE为剪切波弹性成像
图2 正常对照腮腺SWE检查图像注：32岁女性，腮腺剪切波速度测量值为1.66 m/s；SWE为剪切波弹性成像
表1 两组腮腺厚度和下颌下腺体积的比较(±s)
项目 对照组(n＝87) PTC组(n＝113) t值 P值
右侧下颌下腺体积(cm3) 8.29±0.24 7.55±0.47 13.40 <0.05
左侧下颌下腺体积(cm3) 8.31±0.41 7.55±0.64 9.65 <0.05
右侧腮腺厚度(mm) 18.08±0.33 17.48±0.52 9.40 <0.05
左侧腮腺厚度(mm) 18.06±0.38 17.50±0.51 8.57 <0.05
表2 两组腮腺和下颌下腺的SWV比较(m/s, ±s)
项目 PTC组(n＝113) 对照组(n＝87) t值 P值
右侧下颌下腺 2.22±0.21 1.90±0.13 12.49 <0.05
左侧下颌下腺 2.23±0.22 1.93±0.15 10.91 <0.05
右侧腮腺 2.29±0.23 1.90±0.15 13.72 <0.05
左侧腮腺 2.21±0.23 1.86±0.14 12.52 <0.05
表3 不同RAI治疗剂量的两组PTC患者腮腺厚度和下颌下腺体积的比较(±s)
项目 单次RAI治疗组(n＝36) 多次RAI治疗组(n＝77) t值 P值
右侧下颌下腺体积(cm3) 7.55±0.41 7.56±0.51 －0.10 0.92
左侧下颌下腺体积(cm3) 7.55±0.44 7.54±0.61 0.09 0.93
右侧腮腺厚度(mm) 17.49±0.40 17.46±0.57 0.28 0.78
左侧腮腺厚度(mm) 17.50±0.39 17.51±0.42 －0.12 0.90
表4 不同RAI治疗剂量的两组PTC患者腮腺和下颌下腺SWV的比较(m/s，±s)
项目 单次RAI治疗组(n＝36) 多次RAI治疗组(n＝77) t值 P值
右侧下颌下腺 2.20±0.19 2.23±0.24 －0.66 0.51
左侧下颌下腺 2.23±0.18 2.24±0.26 －0.21 0.84
右侧腮腺 2.29±0.20 2.31±0.23 －0.45 0.65
左侧腮腺 2.21±0.20 2.23±0.19 －0.51 0.61
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