高频超声在桥本甲状腺炎与甲状腺功能亢进症鉴别诊断中的价值
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摘要
目的探讨高频超声在桥本甲状腺炎与甲状腺功能亢进症鉴别诊断中的价值。方法选择2014年4月至2016年4月商丘市第四人民医院收治的78例桥本甲状腺炎患者(桥本甲状腺炎组)和72例甲状腺功能亢进症患者(甲状腺功能亢进症组)为研究对象,所有患者行高频超声检查,对2组患者高频超声检查结果进行比较。结果高频超声图像显示,2组患者在甲状腺大小、甲状腺内部回声、甲状腺合并结节样改变、颈部淋巴结方面比较差异有统计学意义(P <0. 05),但2组患者甲状腺内部血流情况比较差异无统计学意义(P> 0. 05)。桥本甲状腺炎组患者甲状腺上动脉收缩期峰值流速、舒张末期流速显著低于甲状腺功能亢进症组(P <0. 05),但2组患者甲状腺上动脉血流阻力指数比较差异无统计学意义(P> 0. 05)。结论桥本甲状腺炎与甲状腺功能亢进症的高频超声图像特征存在较大差异,高频超声检查对桥本甲状腺炎和甲状腺功能亢进症的鉴别诊断具有一定价值。
Objective To investigate the value of high-frequency ultrasound in differential diagnosis of Hashimoto' s thyroiditis and hyperthyroidism. Methods A total of 78 patients with Hashimoto's thyroiditis( Hashimoto's thyroiditis group)and 72 patients with hyperthyroidism( hyperthyroidism group) in the Fourth People' s Hospital of Shangqiu City from April2014 to April 2016 were selected as the subjects. All patients were examined by high-frequency ultrasound,and the results of high-frequency ultrasound were compared between the two groups. Results High-frequency ultrasound images showed that there was significant difference in the thyroid size,internal echo of thyroid gland,thyroid nodular changes and cervical lymph node enlargement between the two groups( P < 0. 05); but there was no significant difference in intrathyroidal blood flow between the two groups( P > 0. 05). The peak systolic flow velocity and end diastolic flow velocity of superior thyroid artery in Hashimoto's thyroiditis group were significantly lower than those in hyperthyroidism group( P < 0. 05),but there was no significant difference in resistance index of superior thyroid artery between the two groups( P > 0. 05). Conclusion There are quite differences in the characteristics of high-frequency ultrasound images between Hashimoto' s thyroiditis and hyperthyroidism. High-frequency ultrasound examination has a certain value in the differential diagnosis of Hashimoto' s thyroiditis and hyperthyroidism.
Objective To investigate the value of high-frequency ultrasound in differential diagnosis of Hashimoto' s thyroiditis and hyperthyroidism. Methods A total of 78 patients with Hashimoto's thyroiditis( Hashimoto's thyroiditis group)and 72 patients with hyperthyroidism( hyperthyroidism group) in the Fourth People' s Hospital of Shangqiu City from April2014 to April 2016 were selected as the subjects. All patients were examined by high-frequency ultrasound,and the results of high-frequency ultrasound were compared between the two groups. Results High-frequency ultrasound images showed that there was significant difference in the thyroid size,internal echo of thyroid gland,thyroid nodular changes and cervical lymph node enlargement between the two groups( P < 0. 05); but there was no significant difference in intrathyroidal blood flow between the two groups( P > 0. 05). The peak systolic flow velocity and end diastolic flow velocity of superior thyroid artery in Hashimoto's thyroiditis group were significantly lower than those in hyperthyroidism group( P < 0. 05),but there was no significant difference in resistance index of superior thyroid artery between the two groups( P > 0. 05). Conclusion There are quite differences in the characteristics of high-frequency ultrasound images between Hashimoto' s thyroiditis and hyperthyroidism. High-frequency ultrasound examination has a certain value in the differential diagnosis of Hashimoto' s thyroiditis and hyperthyroidism.
引文
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[9]郑慧娟,魏璠,柏力萄,等.基于中医传承辅助系统治疗桥本甲状腺炎的组方规律[J].世界中医药,2018,13(9):2346-2351.
[10]赵新宇,苗凤玲,王俊青,等.甲状腺毗邻结构的高频超声研究[J].中国医学计算机成像杂志,2016,22(4):361-367.
[11]王娜.超声在鉴别甲状腺功能亢进与桥本氏甲状腺炎中的价值分析[J].中国现代药物应用,2016,10(16):28-29.
[12] GOICHOT B,CARON P,LANDRON F,et al. Clinical presentation of hyperthyroidism in a large representative sample of outpatients in France:relationships with age,aetiology and hormonal parameters[J]. Clin Endocrinol,2016,84(3):445-451.
[13]潘竞霞,何小莲,张瑾,等.甲状腺功能亢进症中医辨证与彩色多普勒超声影像特征的相关性研究[J].四川中医,2017,35(8):35-37.
[14]刘海波.弹性超声成像技术对桥本氏甲状腺炎合并结节的诊断观察[J].北京医学,2017,39(4):440-441.
[15] RAKOV H,ENGELS K,HNES G S,et al. Sex-specific phenotypes of hyperthyroidism and hypothyroidism in aged mice[J]. Biol Sex Differ,2016,8(1):38-48.
[16]许瑞霞,王正辉,郭俊敏.超声对桥本甲状腺炎的诊断及误诊分析[J].山西医药杂志,2016,45(14):1649-1650.
[2]邵华强,张晨晨,管琳,等.桥本氏甲状腺炎与弥漫性甲状腺肿的超声特点及其中医证型分析[J].中国中西医结合影像学杂志,2014,12(5):452-454.
[3]吕大民,张芳,吴迪.超声弹性成像技术对桥本氏甲状腺炎合并良恶性结节的诊断价值[J].实用医院临床杂志,2018,15(1):56-59.
[4]朱继红,文珂.高频超声、弹性成像联合超声造影对甲状腺实性结节的诊断价值[J].中国现代医学杂志,2016,26(5):83-86.
[5]中华医学会内分泌学分会《中国甲状腺疾病诊治指南》编写组.中国甲状腺疾病诊治指南:甲状腺炎[J].中华内科杂志,2008,47(9):784-788.
[6]中华医学会内分泌学分会《中国甲状腺疾病诊治指南》编写组.中国甲状腺疾病诊治指南:甲状腺功能亢进症[J].中华内科杂志,2007,46(10):876-882.
[7] HAREEZ N B,SHAW J,LOCHNAN H. The impact of 2016 ATA guideline for diagnosis and management of hyperthyroidism on the frequency of TRAb measurement[J]. Can J Diabetes,2017,41(5):S41.
[8]何珂,胡源,朱丽华,等.甲状腺功能亢进症患者中桥本甲状腺炎的比例及其生化和病理特征[J].中国全科医学,2017,20(2):214-218.
[9]郑慧娟,魏璠,柏力萄,等.基于中医传承辅助系统治疗桥本甲状腺炎的组方规律[J].世界中医药,2018,13(9):2346-2351.
[10]赵新宇,苗凤玲,王俊青,等.甲状腺毗邻结构的高频超声研究[J].中国医学计算机成像杂志,2016,22(4):361-367.
[11]王娜.超声在鉴别甲状腺功能亢进与桥本氏甲状腺炎中的价值分析[J].中国现代药物应用,2016,10(16):28-29.
[12] GOICHOT B,CARON P,LANDRON F,et al. Clinical presentation of hyperthyroidism in a large representative sample of outpatients in France:relationships with age,aetiology and hormonal parameters[J]. Clin Endocrinol,2016,84(3):445-451.
[13]潘竞霞,何小莲,张瑾,等.甲状腺功能亢进症中医辨证与彩色多普勒超声影像特征的相关性研究[J].四川中医,2017,35(8):35-37.
[14]刘海波.弹性超声成像技术对桥本氏甲状腺炎合并结节的诊断观察[J].北京医学,2017,39(4):440-441.
[15] RAKOV H,ENGELS K,HNES G S,et al. Sex-specific phenotypes of hyperthyroidism and hypothyroidism in aged mice[J]. Biol Sex Differ,2016,8(1):38-48.
[16]许瑞霞,王正辉,郭俊敏.超声对桥本甲状腺炎的诊断及误诊分析[J].山西医药杂志,2016,45(14):1649-1650.