超声弹性成像诊断亚急性甲状腺炎的价值分析

Value of ultrasound elastography in diagnosis of subacute thyroiditis

目的探讨亚急性甲状腺炎(SAT)在彩色多普勒超声、超声弹性成像上的声像图特征,及二者在临床的应用价值。方法对临床确诊的SAT住院患者22例的超声图像进行回顾性分析总结,观察比较SAT彩色多普勒超声与超声弹性成像特征。结果 22例共47个病灶中,17例共39个病灶二维声像图表现为病灶区局限性或弥漫性从外至内渐进性减低,似地图样、泼墨样和蟹足样,无球体感及占位效应感,无包膜;5例共8个病灶表现为无回声区;CDFI显示35个病灶区周边点线状较丰富血流信号;28个病灶区内未见明显血流信号,19个病灶内可见少许血流信号。12例共29个SAT早期病灶超声弹性成像示:18个病灶弹性分级评为Ⅲ级,11个病灶弹性分级评为Ⅳ级,病灶弹性渲染以蓝色为主;弹性图显示的病灶面积大于二维超声显示的病灶面积,差异有统计学意义(P<0.05)。结论 SAT在彩色多普勒超声以及超声弹性图像上均具有一定的特征性表现,可为临床诊断和治疗提供可信的依据。

Objective To investigate the sonographic features of subacute thyroiditis （SAT） on color Doppler ultrasound and elastography, and to evaluate the clinical application value. Methods The ultrasound images of 22 patients with clinical diagnosed SAT were retrospectively analyzed and summarized. The sonographic features on color Doppler ultrasound and elastography were compared. Results In 22 cases（47 lesions）, 17 cases（39 lesions） showed localized or diffused progressive hypoechoic area from outside to inside on two-dimensional sonogram, like a map or ink sample, crab-like, without the sphere and occupying effect, with no capsule; 5 cases （8 lesions） showed no echo area; CDFI showed surrounding linear rich blood flow signals in 35 lesions, no blood flow signals in 28 lesions, a little blood signal in 19 lesions. In the 12 eases（29 lesions） of early phase SAT, elastography showed that 18 lesions were in grade Ⅲ, 11 lesions were in grade Ⅳ, blue was shown in main area of the lesions; the lesion area revealed by elastography was larger than that by two-dimensional ultrasound, the difference was statistically significant（P〈0.05 ）. Conclusion SAT has some special features in color Doppler ultrasound and elastography images, which can provide reliable basis for clinical diagnosis and treatment.