彩色多普勒超声在甲状腺功能亢进症与桥本氏甲状腺炎鉴别诊断中的价值

THE DIAGNOSIS VALUE OF COLOR DOPPLER SONOGRAPHY ON HYPERTHYOIDISM AND HASHIMOTO'S THYROIDITIS

目的:探讨彩色多普勒超声(CDFI)在鉴别诊断甲状腺功能亢进症(简称甲亢)与桥本氏甲状腺炎(简称桥本)中的应用价值。方法:正常对照组30例,甲亢组30例,桥本组30例,二维观察甲状腺大小、形态、回声,CDFI观察甲状腺血流分布情况,PW测量甲状腺上动脉(STA)参数:峰值速度(PSV)、收缩期达峰时间(T)、阻力指数(RI)、心率(HR),计算T/HR。对所得数据采用SPSS11.5软件进行分析。结果:甲亢组PSV、HR较对照组及桥本组明显升高,T、T/HR较对照组及桥本组明显缩短(P<0.01);桥本组PSV较对照组明显升高(P<0.01);三组之间RI值差异无统计学意义。以PSV=70.16cm/s、T/HR=1.07为截断值鉴别甲亢和桥本的灵敏性分别为88.3%、53.3%;特异性分别为78.3%、86.7%;ROC曲线下面积分别为0.95和0.73。结论:彩色多普勒超声作为对甲状腺疾病的辅助检查,为临床诊断及治疗提供客观参考依据,在甲亢和桥本的鉴别诊断中有着较高的临床应用价值。

Objective： To investigate the value of color doppler flow imaging （CDFI）in discriminating hyperthyroidism and Hashimoto＇ s thyroiditis. Methods： 30 normal subjects （ N group） , 30 patients with hyperthyroidism（ H group）, and 30 patients with Hashimoto＇s Thyroiditis （T group）were enrolled. The dimensions,echos and morphology of the thyroid were determined with two-dimensional （2D） ultrasonography. The blood flow of thyroid were observed with CDFI. Pulsed Quantitive indices of superior thyroid arterysuch （ STA ） such as peak systolic velocity （ PSV ）, time- to- peak velocity （ T）, resistance index（RI）, heart rate （HR）were measured by pulsed-wave doppler（PW） and T/HR was calculated. All the datas were analysed by the SPSS11.5 statistical software. Results：PSV and HR of H group were significantly higher compared with T group and N group（ P〈0.01 ）. T and T/HR of H group were significantly shorter than T group and N group（ P〈0.01 ）. PSV of T group was significantly higher compared with N group. RI of the three groups didn＇t have statistical significance. When considering PSV = 70.16cm/s as the cut off value to differentiate hyperthyroidism and Hashimoto＇ s Thyroiditis, the sensitivity,specificity and the area of ROC was 88.3% ,86.7% ,and 0.73. When the cut off value of T/HR= 1.07was considered for discrimination, the sensitivity, specificity and the area of ROC was 53.3 % ,78.3 %, and 0.95, respectively. Conclusions： As an assistant examination, CDFI could provide an objective basis for determinating hyperthyroidism and Hashimoto＇s Thyroiditis.