桥本氏甲状腺炎不同功能状态下的超声指标对比分析

目的:探讨不同甲状腺功能状态下的桥本氏甲状腺炎(HT)患者的超声声像图各指标差异。方法:将经病例、穿刺细胞学及实验室确诊的70例HT患者划分为HT甲功能正常组(n=21)、HT甲亢组(n=25)及HT甲减组(n=24),并选取同期健康者25例为对照组,测量4组甲状腺大小、上动脉血管内径及血流参数,观察实质回声、血流分布情况。结果:3组HT患者的甲状腺侧叶宽径、厚径及峡部厚径均大于照组,各组间的侧叶厚径差异具有统计学意义(P<0.05),HT甲亢组的侧叶长径明显大于其他组,差异具有统计学意义(P<0.05);HT甲亢组、HT甲功正常组的实质回声以弥漫性减低、局限性片状减低为主,HT甲减组以弥漫性减低伴纤维条索样强回声、结节样的回声改变为主;HT甲功正常组的实质血流以0、Ⅰ级为主,HT甲减组以Ⅰ、Ⅱ级血流信号为主,HT甲亢组的实质血流以Ⅱ、Ⅲ级为主。PSV、EDV值在各组间均有差异;HT甲亢组的血管内径明显大于其它组,差异具有统计学意义(P<0.05),对照组RI值低于其它组,但差异无统计学意义(P>0.05)。结论:超声检查对HT甲状腺功能的评价有一定的参考价值。

Analysis of comparison of ultrasound indexes under different functional statuses of Hashimoto's thyroiditis

Objective:To explore the differences among ultrasound images in patients with Hashimoto's thyroiditis (HT) under different functional statuses.Methods:A total of 70 patients diagnosed as HT by records,puncture cytology and laboratory examinations were divided into HT normal thyroid function group (n=21),HT hyperthyroidism group (n=25) and HT hypothyroidism group (n=24),and another 25 healthy people served as control group.Thyroid size,upper arterial diameter and blood flow parameters were measured,and parenchyma echo and blood flow distribution were observed.Results:The width diameter and thickness diameter of lateral thyroid lobe and the thickness of thyroid isthmus in 3 HT groups were markedly longer than those in control group,and there were significant differences among groups in the thickness diameter of lateral lobes (P<0.05),whereas HT hyperthyroidism group was evidently longer in the length diameter of lateral lobe than other groups,the difference was statistically significant (P<0.05).The parenchyma echo focused on diffuse reduction and limited flaky reduction in HT hyperthyroidism group and HT normal thyroid function group,while on diffuse reduction combined with fibrous band-like strong echo and nodular echo change in HT hypothyroidism group.Parenchyma blood flow was mainly in classes 0 and I in HT normal thyroid function group,in classes I and II in HT hypothyroidism group and in classes II and III in HT hyperthyroidism group.There were significant differences among groups in peak systolic velocity (PSV) and end diastolic velocity (EDV).Vascular diameter was notably wider in HT hyperthyroidism group than that in other groups,and there were significant differences (P<0.05).And control group was lower in resistance index (RI) than other groups,and but the differences were not statistically significant (P>0.05).Conclusion:Ultrasound examination has certain reference value in evaluating thyroid function of patients with HT.