二维及彩色多普勒超声对桥本甲状腺炎的诊断价值

Value of two-dimensional and color Doppler ultrasonography in diagnosis of Hashimoto's thyroiditis

目的探讨二维及彩色多普勒超声对于不同时期桥本甲状腺炎(Hashimoto's thyroiditis,HT)的诊断价值。方法应用二维及彩色多普勒超声对60例HT患者进行甲状腺检查,根据甲状腺功能检查分为HT甲状腺功能亢进组(HT甲亢组)22例,HT甲状腺功能正常组(HT甲功正常组)15例,HT甲状腺功能减退组(HT甲减组)23例,并与25例正常对照组比较。结果①4组患者甲状腺侧叶的前后径比较,HT甲减组>HT甲亢组>HT甲功正常组>正常对照组,差异有统计学意义,3组甲状腺峡部的厚度测值均较正常对照组增大,HT甲减组峡部厚度较其余各组显著增厚(P<0.05);②HT甲亢组及HT甲功正常组的实质回声以Ⅰ级为主,HT甲减组以Ⅱ级为主。HT甲减组网格状强回声的发生率高于其他各组(P<0.05);③各组在实质内血流的分布范围均存在差异,HT甲亢组以Ⅱ级、Ⅲ级为主,HT甲功正常组以0级、Ⅰ级为主,HT甲减组以Ⅰ级、Ⅱ级为主;④各组的甲状腺上动脉测值比较,HT甲亢组>HT甲减组>HT甲功正常组,差异有统计学意义(P<0.05),3组HT患者的阻力指数测值间差异无统计学意义。结论二维超声及彩色多普勒超声检查对HT不同时期的诊断具有重要意义。

Objective To explore the value of two-dimensional （2D） and color Doppler uhrasonography in diagnosis of Hashimoto＇s thyroiditis （HT） with different thyroid functions. Methods A total of 60 HT patients and 25 normal control persons were enrolled. All the patients were examined with 2D and color Doppler ultrasonography. Results ①The thickness of the lateral lobe in three HT groups were greater than those in the normal control. There was a significant difference （ P 〈 0.01 ） between the thicknesses of the gland in each group. The thickness of the isthmus in the HT hypothyroidism group was greater than that in the others. ②The HT patients with hyperthyroidism and euthyroidism had 2D pattern I , while the HT patients with hypothyroidism had 2D pattern Ⅱ. The prevalence of gridding hyperechoic in HT patients with hypothyroidism was significantly higher than the other groups （ P 〈 0.05 ）. ③The HT patients with hyperthyroidism showed color Doppler flow imaging （CDFI） pattern Ⅱ and pattern Ⅲ. The HT patients with euthyroidism showed CDFI pattern 0 and pattern Ⅰ . The HT patients with hypothyroidism showed CDFI pattern Ⅰ and pattern Ⅱ. ④There was a significant difference in peak systolic velocity （PSV） of superior thyroid artery among the four groups （ P 〈 0.05 ）. The PSV in HT patients with hyperthyroidism was obviously higher than that in HT patients with hypothyroidism and euthyroidism, and the PSV in HT patients with hypothyroidism was also higher than that in HT patients with euthyroidism. There was not any significant difference in RI in the three HT groups. Conclusion The 2D and color Doppler ultrasonography can be applied to diagnose Hashimoto＇s thyroiditis with different thyroid functions.