声触诊组织量化成像诊断桥本氏病的初步研究

Preliminary study on the diagnosis of Hashimoto disease with virtual touch tissue imaging quantification

目的探讨声触诊组织量化成像(virtual touch tissue imaging quantification,VTIQ)诊断桥本氏病(Hashimoto disease,HD)的临床价值。方法选择2015年7月—2016年6月在昆明医科大学第五附属医院确诊的50名HD患者为病例组,共100例病变组织,另选择甲状腺血清学及甲状腺功能检查正常的50名志愿者(100例受检组织)作为对照组,所有入组者均采用VTIQ技术检测甲状腺组织的剪切波速度(shear wave velocity,SWV)值,将HD患者甲状腺组织与正常甲状腺组织的SWV值进行比较。计量资料比较采用t检验,多组比较采用方差分析,P<0.05为差异有统计学意义。结果病例组的SWV均值为(3.15±0.37)m/s,对照组的SWV为(2.30±0.03)m/s,对比差异有统计学意义(P<0.05)。病例组各亚组SWV均值:甲功正常组为(2.99±0.47)m/s,亚临床甲减组为(3.17±0.09)m/s,临床甲减组为(3.28±0.33)m/s,亚组间两两比较,甲功正常组与亚临床甲减组,亚临床甲减组与临床甲减组之间的SWV均值差异性均无统计学意义(均P>0.05);甲功正常组与临床甲减组比较,SWV均值对比差异有统计学意义(P<0.05)。结论VTIQ作为超声弹性成像的一项新技术,对于诊断及评估病变组织的硬度变化具有一定的实用价值。

Objective To investigate virtual touch tissue imaging quantification（VTIQ） diagnosis of the clinical value of Hashimoto disease（HD）.Methods From July 2015 to June 2016,50 HD patients with a total of 100 cases of lesions were diagnosed in the Fifth Hospital Affiliated of Kunming Medical University.Another 50 volunteers of whose thyroid serology and thyroid function tests were normal（100 cases examined tissues） as the control group.The shear wave velocity（SWV） value of all hyroid tissues of subjects were detected by VTIQ technique.The SWV values of the thyroid tissue of the HD patients were compared with the SWV values of the normal thyroid tissue of the control group.The difference of subgroup of the case group compared by the Tamhane T2,Dunnett T3.Measurement data was processed by t test,ANOVA were used between the three group,the result of P〈0.05 was considered statistically significant.Results The mean value of SWV in the case group was（3.15±0.37）m/s,and the SWV of the control group was（2.30±0.03）m/s,and the difference was significant（P〈0.05）.The SWV of thyroid function normal group were（2.99±0.47）m/s,sub-clinical hypothyroidism group were（3.17±0.09）m/s,clinical hypothyroidism group were（3.28±0.33）m/s,comparisons between the subgroups were with statistical significance（all P〈0.05）,the difference between the euthyroid group and the sub-clinical hypothyroidism group,subclinical hypothyroidism and clinical hypothyroidism group had no statistically significant（P〉0.05）,the difference between euthyroid group and clinical hypothyroidism group were significant（P〈0.05）.Conclusion VTIQ as a new technology of ultrasonic elastographyn has certain practical valuefor diagnosis of HD and can be the assessment of diseased tissue hardness change.