剪切波弹性成像技术在桥本甲状腺炎诊断中的价值

Value of Shear Wave Elastography in the Diagnosis of Hashimoto’s Thyroiditis

目的:研究剪切波弹性成像技术(SWE)在桥本甲状腺炎(HT)诊断中的价值。方法:选取2019年5月至2021年11月在深圳市第二人民医院就诊的患者68例为研究对象,将41例临床确诊为HT的患者作为观察组,27例甲状腺正常者作为对照组,应用SWE测量两组甲状腺弹性平均值(Mean)并进行比较;根据甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TgAb)、是否合并甲状腺功能异常,将观察组进一步分TPOAb极高组、升高组、正常组和TgAb极高组、升高组、正常组以及甲功正常组、甲亢组和甲减组,分析TPOAb、TgAb、甲状腺功能与Mean之间的关系。结果:(1)观察组Mean为(27.59±12.38)kPa,对照组为(11.96±3.29)kPa,观察组的甲状腺较对照组更硬,差异具有统计学意义(P<0.05);(2)受试者操作特征曲线(ROC)分析结果显示,Mean诊断HT的最佳截断值为19.5 kPa;(3)在TPOAb的检测高限值1300 IU·mL^(-1)以下,TPOAb与Mean呈显著正相关(r=0.873,P<0.05),而在TgAb的检测高限值500 IU·mL^(-1)以下,TgAb与Mean无相关性(P>0.05);甲功正常组、甲亢组和甲减组的Mean比较,差异无统计学意义(P>0.05)。结论:应用SWE测量Mean有助于诊断HT。HT患者的甲状腺Mean高于正常甲状腺,且在检测高限值1300 IU·mL^(-1)以下与患者的TPOAb水平呈正相关,甲状腺功能不影响Mean。

Objective To study the value of shear wave elastography (SWE) in the diagnosis of Hashimoto’s thyroiditis (HT).Methods A total of 68 patients treated in Shenzhen Second People’s Hospital from May 2019 to November 2021 were selected as the research objects,41 patients with clinically diagnosed HT were selected as the observation group,and 27 patients with normal thyroid were selected as the control group.The mean value of thyroid elasticity (Mean) was measured by SWE and compared between the two groups.According to thyroid peroxidase antibody (TPOAb),thyroglobulin antibody (TgAb),and whether combined with thyroid dysfunction,the observation group was further divided into TPOAb extremely high group,elevated group,normal group,TgAb extremely high group,elevated group,normal group,normal thyroid function group,hyperthyroidism group and hypothyroidism group.The relationship between TPOAb,TgAb,thyroid function and Mean was analyzed.Results (1) Mean in the observation group was (27.59±12.38) kPa and that in the control group was (11.96±3.29) kPa.The thyroid tissue in the observation group was harder than that in the control group,and the difference was statistically significant (P < 0.05);(2) The results of receiver operating characteristic curve (ROC) analysis showed that the cut-off value for Mean diagnosis of HT was 19.5 kPa;(3) There was a significant positive correlation between TPOAb and Mean (r=0.873,P < 0.05) below the upper limit of TPOAb of 1300 IU·mL^(-1),while there was no correlation between TGAb and Mean (P > 0.05) below the upper limit of TGAb of 500 IU·mL^(-1);There was no significant difference in Mean between normal thyroid function group,hyperthyroidism group and hypothyroidism group (P > 0.05).Conclusion It is helpful to diagnose HT by using SWE to measure Mean.Mean in HT patients is higher than that in normal patients,and it has a positive correlation with TPOAb below the upper limit of 1300 IU·mL^(-1).Thyroid function does not affect Mean.