超声剪切波弹性成像在桥本甲状腺炎临床诊断中的价值

Value of ultrasound shear wave elasticity imaging in diagnosis of Hashimoto's thyroiditis

目的探讨剪切波弹性成像技术(SWE)对桥本甲状腺炎(HT)不同分期的诊断价值。方法 104例经临床确诊的HT患者,根据甲状腺功能状态分为HT甲亢组(26例)、HT甲功正常组(29例)、HT亚临床甲减组(27例)和HT临床甲减组(22例)。同期选择健康志愿者作为健康对照组(50例)。利用SWE技术测量所有受检者甲状腺组织的杨氏模量值。采用Spearman相关分析法分析甲状腺组织杨氏模量值与甲状腺峡部厚度、甲状腺微粒体抗体(TMAb)、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呈递增趋势(P<0.01)。HT甲亢组剪切波弹性模量值低于HT甲功正常组、HT亚临床甲减组、HT临床甲减组,差异均有统计学意义(P均<0.05)。HT甲功正常组剪切波弹性模量值低于HT亚临床甲减组、HT临床甲减组,差异有统计学意义(P均<0.05)。结论剪切波弹性成像杨氏模量值与桥本甲状腺炎不同分期患者临床表现有一定相关性,提示超声弹性成像对桥本甲状腺炎病程分期有一定的诊断价值。

Objective To investigate the correlation between Young's modulus of the thyroid tissue measured by in shear wave elastography(SWE) and the clinical manifestations of Hashimoto's thyroiditis in different stages. Methods A total of 104 patients with the clinical diagnosis of Hashimoto's thyroiditis were enrolled in this study, including 26 with hyperthyroidism,29 with normal thyroid function, 27 with subclinical hypothyroidism, 22 with clinical hypothyroidism, with 50 healthy volunteers serving as the healthy control group. All the subjects underwent SWE to obtain the Young's modulus value of the thyroid tissue. Univariate analysis of variance was used to compare the Young's modulus among the groups, and Pearson correlation analysis was used to analyze the correlation between the Young's modulus of the thyroid tissue and serum levels of thyroid microsomal antibody(TMAb) and thyroid globulin antibody(TGAb). Results In the 4 groups of patients, the Young's modulus increased significantly in the order of hyperthyroidism group, normal thyroid function group, subclinical hypothyroidism group and clinical hypothyroidism group(F=60.983, P<0.01). The Young's modulus was significantly lower in hyperthyroidism group than in the other 3 groups(P<0.05), and was significantly lower in normal thyroid function group than in subclinical hypothyroidism group and clinical hypothyroidism group(P<0.05). Conclusion The Young's modulus of the thyroid tissue measured by shear wave elastography is related with the clinical manifestations of Hashimoto's thyroiditis in different stages, but the relevance needs to be further confirmed by multi-center, randomized, controlled studies involving a larger sample size.