剪切波弹性成像技术对桥本甲状腺炎患者不同甲状腺功能状态的研究

The value of shear wave elastography in different thyroid function status of Hashimoto′s thyroiditis

目的探讨剪切波弹性成像(SWE)技术对桥本甲状腺炎(HT)患者不同甲状腺功能状态的诊断价值。方法收集2013年2至9月中国医科大学附属第一医院经临床确诊的103例HT患者,其中甲状腺功能亢进期24例(HT甲亢组),甲状腺功能正常期31例(HT甲功正常组),亚临床甲状腺功能减退期26例(HT亚临床甲减组),临床甲状腺功能减退期22例(HT临床甲减组)。选择同期50名健康志愿者作为健康对照组。采用SWE技术测量所有受试者甲状腺组织的杨氏模量值。采用单因素方差分析比较各组受试者甲状腺组织杨氏模量值差异;采用独立样本t检验比较各组受试者甲状腺左、右叶杨氏模量值差异;采用Pearson相关分析分析甲状腺组织杨氏模量值与血清促甲状腺激素(TSH)浓度、甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)滴度的相关性。结果健康对照组、HT甲亢组、HT甲功正常组、HT亚临床甲减组、HT临床甲减组甲状腺组织杨氏模量值依次升高,分别为(16.39±3.37)、(23.61±5.59)、(26.51±8.31)、(28.93±11.46)、(31.54±7.92)k Pa,组间差异有统计学意义(F=45.453,P<0.01)。各组受试者甲状腺左、右叶杨氏模量值差异均无统计学意义。HT患者甲状腺组织杨氏模量值与血清TPOAb、TGAb滴度均呈正相关(r=0.592、0.333,均P<0.01),与血清TSH浓度无明显相关性(r=0.117,P>0.05)。结论 SWE技术测量甲状腺组织杨氏模量值有助于评价HT患者的甲状腺功能状态。

Objective To investigate the diagnostic value of shear wave elastography（SWE） in the different thyroid function status of Hashimoto′s thyroiditis（HT）.Methods One hundred and three cases clinically diagnosed as HT in the First Hospital of China Medical University from February to September 2013 were analyzed.According to the function of thyroid,the patients were classifi ed into four groups：the hyperthyroidism group（n=24）,the euthyroidism group（n=31）,the subclinical hypothyroidism group（n=26） and the clinical hypothyroidism group（n=22）.Fifty volunteers with normal thyroid functions were enrolled as control group.All subjects underwent SWE detection to obtain the Young′s modulus value of thyroid tissue.One-factor ANOVA was used to compare each group subjects′ Young′s modulus value of thyroid tissue.Independent sample t-test was used to compare each group subjects′ Young′s modulus value of the left and right lobe thyroid tissue.Pearson correlation analysis was used to analyzed correlation between Young′s modulus value of thyroid tissue and serum thyroidstimulating hormone（TSH）,thyroid-peroxidase antibody（TPOAb）,thyroid globulin antibody（TGAb） levels.Results The Young′s modulus value increased in the order of the control group,the hyperthyroidism group,the euthyroidism group,the subclinical hypothyroidism group and the clinical hypothyroidism group.The corresponding Young′s modulus value were（16.39±3.37） k Pa,（23.61±5.59） k Pa,（26.51±8.31） k Pa,（28.93±11.46） k Pa and（31.54±7.92） k Pa.Differences between groups was statistically significant.The Young′s modulus value of the left lobe and right lobe in each group was not signifi cant.The Young′s modulus value of thyroid tissue and the serum TPOAb or TGAb level was positive correlation（r=0.592,0.333,respectively,both P 〈0.01）.There is no obvious correlation between the Young′s modulus value of thyroid tissue and the serum TSH level（r=0.117,P 〉0.05）.Conclusion SWE is valuable to assess the different thyroid function status of HT by measure the Young′s modulus value of thyroid tissue.