不同临床分期桥本甲状腺炎的超声弹性成像分析

Elastosonography in Diagnosis of Hashimoto′s Thyroiditis in Different Clinical Stages

目的 分析不同临床分期桥本甲状腺炎的超声弹性成像。方法 随机选择医院2018年2月1日至2020年2月1日诊治的桥本甲状腺炎患者93例。参考血清促甲状腺激素(TSH)水平较患者分成正常组(33例)、甲亢组(32例)和甲减组(28例)。采用日立HTTACHIHA900彩色超声诊断仪进行诊断。比较三组患者甲状腺大小参数、超声特征、血流分布和弹性指标。结果 甲亢组患者甲状腺长径大于甲减组和正常组(P<0.05),而甲减组患者的甲状腺宽径、厚径、峡部厚径大于甲亢组和正常组(P<0.05)。甲亢组患者回声不均、斑片型率高于甲减组和正常组(P<0.05),甲亢组和甲减组患弥漫型率低于正常组(P<0.05)。三组患者回声不均、斑片型和弥漫型率差异比较有统计学意义(P<0.05)。甲亢组、甲减组和正常组患者0级、Ⅰ级、Ⅱ级、Ⅲ级率差异比较有统计学意义(P<0.05)。三组患者MEAN值差异比较有统计学意义(P<0.05),甲减组患者最低,其次是甲亢组,正常组最高。三组患者SD值差异比较有统计学意义(P<0.05),甲减组最高,甲亢组最低,其次是正常组。三组患者KUET值差异比较无统计学意义(P>0.05)。结论 不同临床分期桥本甲状腺炎的超声弹性成像特征不同,其中甲减和甲亢患者可通过SD、MEAN、特征等进行诊断,建议使用。

Objective To investigate the value of real-time elastosonography in diagnosis of Hashimoto′s thyroiditis in different clinical stages.Methods Ninety-three patients with Hashimoto′s thyroiditis in our hospital from February 1,2018 to February 1,2020 were enrolled, and divided into three groups according to serum thyroid stimulating hormone(TSH)level, normal group(n=33),hyperthyroidism group(n=32)and hypothyroidism group(n=28).All patients received elastosonography examinations.Thyroid size parameters, ultrasonic characteristics, blood flow distribution and elasticity indexes were compared among three groups.Results The long diameter of the thyroid gland was greater in hyperthyroid group than in hypothyroid group and normal group(P<0.05),while the wide diameter, thick diameter and isthmus portion thickness of thyroid gland were greater in hypothyroid group than in hyperthyroid group and normal group(P<0.05).The rate of unevenness type and focal type was significantly higher in hyperthyroidism group than in hypothyroidism group and normal group(P<0.05),while the rate of diffuse type was significantly lower than that in hypothyroidism group and normal group(P<0.05).The rates of grade 0,grade Ⅰ,grade Ⅱ,and grade Ⅲ showed significant difference among three groups(P<0.05).MEAN value was the lowest in hypothyroidism group, followed by hyperthyroidism group, and was the highest in normal group, with statistical difference(P<0.05).SD value among three groups was the highest in hypothyroidism group, followed by normal group, and was the lowest in hypothyroidism group, with statistical difference(P<0.05).No significant difference was found in KUET value(P>0.05).Conclusion Different clinical stages of Hashimoto′s thyroiditis have different ultrasound elastography features, of which SD,MEAN and features are recommended for the diagnosis of hypo-and hyperthyroid patients.