高频超声及背向散射积分对桥本甲状腺炎甲状腺功能变化的诊断价值

目的 探讨桥本甲状腺炎(HT)甲状腺功能变化的回声特点,研究背向散射积分(IBS值)在判断HT甲状腺功能变化中的应用价值.方法 对100例HT患者行超声检查,观察甲状腺超声影像特点并测定其甲状腺IBS值及内分泌水平,分析两者间的联系.结果 100例HT患者中,甲状腺功能亢进(甲亢)30例、甲状腺功能正常30例、甲状腺功能减低(甲减)40例.(1)HT甲亢组与HT功能正常组甲状腺内部回声以局灶性及弥漫性减低多见,该两组在局灶性与弥漫性回声减低中均未见差异(P>0.05);(2)HT甲减患者弥漫性低回声的出现率达到70%,高于HT甲亢、HT功能正常组(P<0.05);(3)HT甲减患者高回声带出现率高于HT甲亢、HT功能正常组(P<0.05);(4)多发结节在HT甲亢组占3.3%,HT功能正常组占16.7%,HT甲减组占30%,各组间差异有统计学意义(P<0.05);(5)HT各组的IBS和IBS%均较正常对照组减低(P<0.05);(6)HT甲减组的IBS和IBS%均较HT甲亢组、HT功能正常组减低(P<0.05); HT甲亢组与HT功能正常组的IBS和IBS%均未见差异(P>0.05).结论 高频超声及背向散射积分可用于HT甲状腺功能的评价.

High Frequency Ultrasonography and Integrated Backscatter in Diagnosis of Hashimoto's Thyroiditis

Objective To evaluate the sonographic characteristics existed in patients with the Hashimotos thyroiditis and apply integrated backscatter (IBS) to thyroid function of Hashimotos thyroditis(HT).Methods Ultrasonography was performed in 100 patients with HT.The appearance of sonographic characteristics on thyroid was surveyed.IBS and serum thyroid hormone levels were determined.The relationship between IBS and serum thyroid hormone levels was analyzed.Results Hyperthyroidism was found in 30 cases,euthyroidism in 30 and hypothyroidism in 40.(1)Focal hypoechoic pattern and diffuse hypoechoic pattern more appeared in the hyperthyroidism and euthyroidism group.The difference of hypoechogenicity didnt exist between the hyperhyroidism and euthyroidism group(P>0.05).(2)Incidence of diffuse hypoechogenicity in the hypothhyroi dism patients was higher than that in the hyperthyroidism、euthyroidism group which was 70%.(3)Incidence of linear hyperechoic in the hypothyroidism patients was higher than that in the hyperthyroidism and euthyroidism group (P<0.05).(4)The differences of the incidence of multi-nodular existed in the three groups.It was 3.3% in hyperthyroidism group,16.7% in euthyroidism group and 30% in hypothyroidism group.The differences among these three groups had statistic meaning (P<0.05).(5)IBS and IBS% in group HT were lower than those in normal people group (P<0.05).(6) IBS and IBS% in hypothyroidism group were lower than those in the hyperthyroidism and euthyroidism group (P<0.05).The difference of IBS and IBS% didnt exist between the hyperhyroidism and euthyroidism group (P>0.05).Conclusions High frequency ultrasonography and IBS are noninvasive and valuable methods to assess thyroid function of hashimotos thyroiditis.