三维能量多普勒血管成像在甲亢和亚临床甲减鉴别诊断中的应用

Application of three-dimensional power Doppler angiography in the differential diagnosis of hyperthyroidism and subclinical hypothyroidism

目的探讨三维能量多普勒血管成像及其定量参数在甲状腺功能亢进(甲亢)与亚临床甲状腺功能减退(亚临床甲减)鉴别诊断中的应用。方法选择甲亢组、亚临床甲减组和正常对照组各40例作为研究对象,对各组研究对象的甲状腺进行检查,获得直方图及定量指标,包括平均灰阶(MG)、血管指数(VI)、血流指数(FI)和血管血流指数(VFI),并进行对比分析。结果甲亢组各项参数均较对照组明显增高(P<0.05);亚临床甲减组MG与对照组比较差异无统计学意义(P>0.05),VI、FI、VFI均较对照组明显增高(P<0.05);亚临床甲减组的MG、FI、VFI明显低于甲亢组(P<0.05),VI与甲亢组比较差异无统计学意义(P>0.05)。结论三维能量多普勒血管成像可以定性定量判定甲状腺的腺体回声水平和血流情况,为甲亢和亚临床甲减的诊断及鉴别诊断提供更多客观依据。

Objective To investigate the value of three-dimensional power Doppler angiography （3D-PDA） in discriminating hyperthyroidism and subclinical hypothyroidism. Methods Forty patients with hyperthyroidism, 40 patients with subclinical hypothyroidism and 40 healthy individuals were enrolled as the hyperthyroidism group, the subclinical hypothyroidism group and the control group. The thyroids of all the subjects in each group were detect- ed by 3D-PDA. Region of interested （ROI） were defined, then the histogram and the quantification indexes were ob- tained, including mean gray （MG）, vascularization index （VI）, flow index （FI）, and vascularization flow index （VFI）. Results The values of MG, VI, FI and VFI in the hyperthyroidism group were significantly higher than those in the control group （P〈0.05）. The values of VI, FI and VFI were significantly higher in the subclinical hypothyroidism group than the control group （P〈0.05）, while MG showed no statistically significant difference between the two groups. The values of MG, FI and VFI were significantly lower in the subclinical hypothyroidism group than the hyperthyroidism group （P〈0.05）, but VI showed no statistically significant difference between the two groups. Conclusion 3D-PDA is a newly developed technique to quantitatively assess the levels of gray and blood flow, which provides more objective and valuable information for the differential diagnosis of hyperthyroidism and subclini- cal hypothyroidism.