彩超在诊断桥本氏甲状腺炎伴亚临床甲状腺功能减退中的应用价值

The diagnostic value of color Doppler ultrasonography in Hashimoto's thyroiditis with subclinical hypothyroidism

目的探讨超声对桥本氏甲状腺炎(HT)伴亚临床甲状腺功能减退的诊断价值。方法回顾性分析21例经临床诊断和实验室证实的HT伴亚临床甲状腺功能减退患者的二维及彩色多普勒超声表现,并与26例单纯性甲亢、30例健康者相对比,比较三组病例甲状腺上动脉(STA)最大血流速度(PSV)、收缩期达峰值时间(T)、阻力指数(RI)、心率(HR)以及T/HR的差异情况。结果 HT伴亚临床甲状腺功能减退时,甲状腺肿大以峡部显著,回声减低不均质,血流信号极其丰富,甲状腺上动脉最大血流速度高于正常组,小于甲亢组(P<0.01),收缩期达峰时间高于甲亢组(P<0.01),HR低于甲亢组(P<0.01),T/HR高于甲亢组(P<0.01)。结论超声作为无创、经济的检查方法,对HT伴亚临床甲状腺功能减退的诊断、鉴别诊断具有重要临床价值。

Objective To evaluate the diagnostic value of ultrasonography in Hashimoto＇s thyroiditis（HT） with subclinical hypothyroidism.Methods Twenty-one cases of Hashimoto＇s thyoiditis with subclinical hypothyroidism,twenty-six cases of simple hyperthyroidism and thirty cases of healthy persons confirmed by clinical and laboratory were analyzed retrospectively about their sonographic characers.Quantitive indices such as peak systolic velocity（PSV）,time-to-peak velocity（T） of superior thyroid artery（STA） were measured on color Doppler flow imaging（CDFI）.Resistanceindex（RI）,the heart rate（HR） of STA,T/HR were measured,and the differences among simple hyperthyroidism,healthy persons and HT with subclinical hypothyroidism were analyzed.Results Of all the Hashimoto＇s thyroiditis with subclinical hypothyroidism patients,there were unsmoothed integume;The echo of isthmus were not homogeneous reduced,and the flow signals enlarged and significant difference in the thickens of isthmus,and irregular thyroid gland with were extremely rich;The PSV of STA in Hashimoto＇s thyroiditis with subclinical hypothyroidism were higher than in normal group（P0.01）,but lower than the hyperthyroid group;The T and T/HR in Hashimoto＇s thyroiditis with subclinical hypothyroidism were higher than those in hyperthyroid group（P0.01）,and the HR in Hashimoto＇s thyroiditis with subclinical hypothyroidism were lower than that in hyperthyroid group（P0.01）.Conclusion As a noninvasive and more convenient examination modality,Color Doppler ultrasound is an important method in the diagnosis and differential diagnosis of Hashimoto thyroiditis with subclinical hypothyroidism.