E成像杨氏模量均值诊断不同类型甲状腺弥漫性病变的临床价值
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摘要
目的探讨实时剪切波弹性成像(SWE)技术在不同类型甲状腺弥漫性病变中的临床应用价值。方法选取门诊首次甲状腺超声检查表现为弥漫性改变的患者186例及同期健康体检者30例(对照组),对实验室及超声检查资料进行回顾分析。所有病例均行彩色多普勒超声及实时SWE检查,获取甲状腺组织的杨氏模量均值(Emean)及标准差值(SD),所有病例均经临床确诊。根据甲状腺功能状态及病变类型不同分为对照组、甲状腺功能亢进组(含亚组:Graves病(GD)组、桥本甲状腺炎(HT)组、亚急性甲状腺炎(SAT)组)及甲状腺功能正常组(含亚组:HT组、SAT组)。结果对照组与甲亢组中各亚组杨氏模量值差异有统计学意义(<0.05),甲亢组中GD组、HT组、SAT组杨氏模量均值及标准差呈依次增高,两两差异均有统计学意义(均<0.05);甲状腺功能正常组中HT组与SAT组杨氏模量均值差异有统计学意义(<0.05)。结论利用SWE技术可准确测定甲状腺杨氏模量值,为临床鉴别初次就诊的各类甲状腺弥漫性病变提供超声检查的新方法。
引文
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[2]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].中华内分泌杂志,2007,46(10):876-882.
[3]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):784-785.
[4]Bahn RS,Burch HB,Cooper DS,et al.Hyperthyroidism and other causes of thyrotoxicosis:management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists[J].Thyroid,2011,21(6):593-646.
[5]唐诗,辛颖.儿童桥本甲状腺炎的研究进展[J].中国中西医结合儿科学,2013,5(6):488-491.
[6]Liu J,Zhang Y,Ji Y,et al.The value of shear wave elastography in diffuse thyroid disease[J].Clin Imaging,2018,49:187-192.
[7]Livolsi VA.The pathology of autoimmune thyroid disease:a review[J].Thyroid Official Journal of the American Thyroid Association,1994,4(3):333.
[8]Mizukami Y,Michigishi T,Kawato M,et al.Chronic thyroiditis:thyroid function and histologic correlations in 601 cases[J].Human Pathology,1992,23(9):980-988.
[9]周仁,张海,谭坤能,等.B超及总T3、总T3/总T4在鉴别Graves病和桥本病甲状腺功能亢进中的应用[J].中华内科杂志,2005,44(6):467-468.
[10]刘媛祎,崔可飞,付超,等.实时剪切波弹性成像评价甲状腺弥漫性疾病的可行性及局限性[J].中国临床医学影像学杂志,2013,24(12):890-892.
[11]Ruchala M,Szczepanek E,Sowinski J.Sonoelastography in de Quervain Thyroiditis[J].JClinEndocrinol Metab,2011,96(2):289-290.
[12]Ruchala M,Szczepanek-Parulska E,Zybek A,et al.The role of sonoelastography in acute,subacute and chronic thyroiditis:a novel application of the method[J].European Journal of Endocrinology,2012,166(3):425-432.