核医学与超声检查对亚急性甲状腺炎的诊断价值

目的探讨核医学与超声检查对亚急性甲状腺炎的诊断价值。方法选取广西壮族自治区民族医院甲状腺专科门诊收治的58例亚急性甲状腺炎患者（病例组）及50例健康人群（对照组）作为研究对象,对病例组患者均行血红细胞沉降率（ESR）、血清游离三碘甲状腺原氨酸（FT3）、血清游离甲状腺素（FT4）、高敏促甲状腺激素（sTSH）、6 h摄碘率（RAIU/6 h）及甲状腺核素扫描,将测定结果与正常值进行比较,同时对两组受试者进行超声检查,观察比较两组甲状腺大小。结果 58例病例组患者,53例FT3和（或）FT4增高,余5例患者FT3、FT4正常,38例sTSH降低。RAIU/6 h：55例〈8%,3例为8%～11%。58例患者ESR均增高,8例显影正常,50例不显影或显影不良。以TH与RAIU/6 h分离现象和（或）核素显像阳性判断疾病诊断阳性,本组58例病例组患者核医学检查阳性率为94.85%（55/58）。对照组甲状腺超声检查显示,甲状腺左叶和右叶宽度与厚度比较,差异无统计学意义（P〉0.05）,病例组患者左右叶宽度和厚度均明显大于对照组（均P〈0.05）。病例组超声检查显示甲状腺单叶或双叶不均匀弥漫性肿大,伴回声增强或片状或点状低回声区,超声检查对58例病例组诊断阳性率为79.31%。结论核医学与超声检查应用于亚急性甲状腺炎的诊断,可通过评价甲状腺功能与形态,提高诊断率,利于将本病与其他甲状腺疾病进行鉴别诊断,降低亚急性甲状腺炎的误诊误治率。

Diagnostic value of nuclear mdicine and ultrasonography on subacute thyroiditis

Objective To investigate the diagnostic value of nuclear mdicine and ultrasonography on subacute thyroiditis.Methods 58 patients with subacute thyroiditis（case group） and 50 cases of healthy people（control group） in special department outpatient of thyroid in National Hospital of Guangxi Zhuang Autonomous Region were selected as research subjects,the case group were detected with ESR,FT 3,FT 4,sTSH,RAIU/6 h and radionuclide thyroid scan, the determination results were compared with the normal value,the subjects of two groups with ultrasonography and the thyroid size were observed.Results 58 patients in the case group,53 cases of FT 3 and（or） FT 4 increased,5 cases of FT 3,FT 4 with normal value,38 cases of sTSH decreased.RAIU/6 h： 55 cases 8%,8%-11% in 3 cases.58 patients with ESR increased,8 cases developed in normal,50 cases were not develop or underdeveloped.The disease diagnosis positive was judged by the separation phenomenon of TH,RAIU/6 h and（or） the positive of radionuclide imaging,the positive rate of nuclear medicine of 58 patients in the case group was 94.85%（55/58）.The thyroid ultrasonography of control group showed that there was no significant difference in the width and thickness of the thyroid left lobe and right lobe（P 0.05）,the width and thickness of the thyroid left lobe and right lobe of case group were significantly greater than the control group（all P 0.05）.Ultrasonography of the case group showed that thyroid single leaf or double leaf uneven diffuse swelling with echogenic or flake or punctate hypoechoic areas,the the positive diagnosis rate of ultrasonography of 58 patients in the case group was 79.31%.Conclusion Nuclear medicine and ultrasonography used in the diagnosis of subacute thyroiditis,can improve the diagnostic by the evaluation of thyroid function and morphology,and conducive to the differential diagnosis of this disease and other thyroid diseases,in order to reduce the misdiagnosis and mistreatment rates of subacute thyroiditis.