颈部淋巴结超声对Graves's病与桥本甲状腺炎的鉴别价值

The value of cervical lymph node ultrasound in differential diagnosis of Graves' s disease and Hashimoto's thyroiditis

目的:探讨颈部淋巴结超声检查对Graves病(Graves’s disease,GD)与桥本甲状腺炎(Hashimoto’s thyroiditis,HT)的鉴别诊断价值。方法:选取GD患者100例和HT患者150例,均行超声检查,比较两组患者颈部淋巴结发现率。结果:GD组和HT组颈部Ⅰ、Ⅲ、Ⅳ、Ⅴ区淋巴结偶有增大,两组比较差异均无统计学意义(P>0.05);颈部Ⅱ区在GD组和HT组均较常发现增大的淋巴结,两组比较差异无统计学意义(93%vs.94%,P>0.05);颈部Ⅵ区淋巴结HT组发现率明显高于GD组,两组比较差异有统计学意义(90%vs.11%,P<0.05)。结论:颈部Ⅵ区淋巴结的发现,对GD与HT的鉴别诊断,尤其是对超声表现相似的GD与HT甲状腺功能亢进期的鉴别诊断具有重要价值。

Objective： To evaluate the value of cervical lymph node ultrasound in differential diagnosis of Hashimoto＇s thyroiditis（HT） and Graves disease（GD）. Methods： One hundred GD cases and 150 HT cases were enrolled in the study. All cases were performed ultrasound examination. The detection rate of cervical lymph nodes was compared between the two groups. Results： The cervical lymph nodes in zones Ⅰ, Ⅲ, Ⅳ and Ⅴ of neck were occasionally enlarged in GD and HT groups without significant difference（P〉0.05）. The lymph nodes in zone Ⅱ of neck were often found in both two groups without significant difference（P〈0.05）. The detection rate of lymph nodes in zone Ⅵ in HT group was significantly higher than that in GD group（90% vs. 11%, P〈0.05）. Conclusion： There is a significant difference in the detection rate of cervical lymph nodes in zone Ⅵ of neck between GD and HT cases. It is of important value in differential diagnosis of GD and HT, especially for HT hyperthyroidism.