声触诊组织定量技术在桥本氏甲状腺炎临床进程中的应用

Application of virtual touch tissue quantification in the different clinical course of Hashimoto’s thyroiditis

目的应用声触诊组织定量(VTQ)技术探讨桥本氏甲状腺炎(HT)在不同临床进程中的组织弹性变化情况。方法回顾性分析153例经临床确诊的HT患者,根据HT的二维超声图像特征分为局灶型(Ⅰ类)、类结节型(Ⅱ类)、弥漫回声减低型(Ⅲ类)、弥漫回声增强型(Ⅳ类),分别对应于HT的临床初期、进展期、活动期、恢复期;另选同期健康体检者50例(正常对照组),应用VTQ技术分析正常对照组与不同时期的HT的剪切波速度(SWV)变化。结果Ⅰ类35例,Ⅱ类59例,Ⅲ类27例,Ⅳ类32例;对照组SWV值与总体HT组比较差异有统计学意义(P=0.000);HT组Ⅰ、Ⅳ类与Ⅱ、Ⅲ类SWV比较差异均有统计学意义(均P=0.000);随HT临床进程的发展SWV值由Ⅰ类逐渐升高至Ⅱ、Ⅲ类达峰值,至Ⅳ类逐渐下降。结论 HT患者组织弹性在不同临床进程中呈现不同变化,随炎症加重组织硬度逐渐升高。

ObjectiveTo explore elastic change in thyroid tissue by virtual touch tissue quantification(VTQ)in thedifferent clinical course of Hashimoto’s thyroiditis(HT).MethodsA total of 153 patients with HT(HT group)who wereclinically and serological diagnosed were retrospectively analyzed.According to the characteristics of two-dimensional ultrasoundimages of HT,the patients were divided into focal type(type Ⅰ),nodular type(type Ⅱ),diffuse echo reduction type(type Ⅲ),and diffuse echo enhancement type(type Ⅳ),respectively,corresponding to early period,advanced period,active period andrecovery period in the clinical course of HT.Another 50 healthy subjects were selected as normal control group.The changes ofshear wave velocity(SWV)in normal control group and in different period of HT were analyzed by VTQ.ResultsThere were 35 cases in type Ⅰ,59 cases in type Ⅱ,27 cases in type Ⅲ and 32 cases in type Ⅳ.The difference of SWV was statisticallysignificant between normal control group and HT group(P=0.000).The differences of SWV were statistically significant betweentype Ⅰ,Ⅳ and type Ⅱ,Ⅲ(all P=0.000). With the development of HT clinical process,the SWV value was rising highergradually from type Ⅰ to type Ⅱ and Ⅲ,and descending gradually in the process of the type Ⅳ.ConclusionThere is asignificant change of the tissue elasticity in the process of HT.The hardness of the thyroid tissue is ascending gradually when theinflammation in HT is aggravated.