应用彩超评价甲状腺动脉栓塞术治疗甲状腺功能亢进的疗效

目的　应用彩超评价甲状腺动脉栓塞术治疗甲状腺功能亢进 (甲亢 )的疗效。方法　 4 2例甲亢患者行甲状腺动脉栓塞术。术前及术后 1、3、6个月用彩超观察腺体回声 ,测量腺体容积及动脉内径 ,多普勒测量血流收缩期最大速度 (Vs)、舒张期最大速度 (Vd)、平均速度 (Vm)、搏动指数 (PI)、阻力系数 (RI) ,计算血流量。并观察各项测值与T3 、T4、促甲状腺激素 (TSH)之间变化关系。结果　术前腺体容积增大为弥漫性、均质或非均质性低回声 ,部分有结节 ,甲状腺动脉及腺体内多级分支动脉多而粗 ,术后腺体容积缩小 ,术后 1～ 3个月腺体回声增强、增粗 ,血管变细而少 ,腺体内仅见星点状血流束 ,时隐时现 ,部分腺体内无血流信号 ,3～ 6个月腺体回声由强逐渐变低或强弱相间 ,分布不均。血流参数各项测值 ,术前与术后比较差异均有显著性 (P <0 .0 5 )。结论　甲状腺动脉栓塞术治疗甲亢近期效果明显 ,彩色多普勒超声对术前明确诊断术后疗效观察具有重要价值。

Evaluation of arterial embolization in treating hyperthyroidism by colour ultrasonography

Objective To assess the effect of arterial embolization in treating hyperthroidism by colour ultrasonography.Methods Forty two cases of hyperthyroidism were treated with thyroid arteries embolization. A few days before and 1, 3, 6 months after embolization, the echograms of thyroids were observed including the volumes of thyroids and the internal diameters of thyroid arteries were measured with colour ultrasonography respectively. The Vs, Vd, Vm, PI, RI were measured with the Doppler and the quantities of blood flow were calculated. The relationships of changes for all these parameters and T 3, T 4 and TSH were analysed. Results Before artery embolization all thyroids were enlarged with diffusely homogenous or heterogenous low echos and nodules in some patients accompanied by widenings of the thyroid arteries and their branches full of blood supply. The volume of thyroids decreased after artery embolization. 1 3 months later the echo of thyroids enhanced and got coarse with decrease of the thyroid vasculature and narrowing of vessel calibers except a few star or spot like blood streams were sometimes seen within the thyroids and no blood flow signals found in some cases. 3 6 months after embolization, the echo of thyroids decreased gradually or unevenly distribnted. All the parameters of blood flow before and after the treatment showed statistically significant differences( P <0.05).Conclusions Embolization of thyroid arteries is a relatively new and effective technique in treating hyperthyrpoidism. Colour Doppler ultrasonography plays an important role for correct diagnosis and prognostication.