彩超在甲亢与亚甲低的首诊与鉴别诊断中的应用

The application of color doppler sonography in differential diagnosis of hyperthyroidism and subclinical hypothyroidism

目的探讨彩色多普勒超声在甲亢与亚甲低鉴别诊断中的价值。方法对经临床及实验室检查确诊的32例甲亢患者和26例亚甲低患者的甲状腺二维及彩色多普勒超声表现及甲状腺上动脉血流参数(Vmax、Vmin和RI)进行观察分析,并与正常组进行对照。结果亚甲低组与甲亢组甲状腺大小均不同程度增大,内部回声增粗,甲状腺内血流信号明显增多;甲状腺上动脉Vmax、Vmin均高于正常组(P<0.01),且甲亢组明显高于亚甲低组(P<0.01,P<0.05);RI两组间比较及与正常组比较均无显著性差异(P>0.05)。结论亚甲低和甲亢的二维及彩色声像图表现极为相似,难以对两病作出鉴别诊断;甲状腺上动脉血流Vmax、Vmin的变化,可作为二者诊断与鉴别诊断的参考依据。

Objective： To explore the value of color Doppler sonography in diagnosis and differential diagnosis of hyprthyroidism（HT） and subclinical hypothyroidism（SHT）.Methods： In 23 patients with hyperthyroidism and 22 with subclinical hypothyroidism diagnosed clinically and confirmed by laboratory examination,conventional and color Doppler sonography of thyroid were demonstrated and the flow parameters of superthyroid artery（Vmax,Vmin,and RI） were measured and compared with normal.Results： In both of HT and SHT,the thyroids were enlarged with rough echo and abundent flow echo.The Vmax and Vmin of superthyroid artery in both of the groups were higher than normal（P0.01） and they were much higher in HT than that in SHT（P0.01,P0.05）.There was no significant difference in RI between the groups.Conclusion：It is difficult to make differential diagnosis between HT and SHT with conventional and color sonography,and the variation of Vmax and Vmin of superthyroid artery can be used as reference of making diagnosis and differetial diagnosis between them.