不同临床类型桥本氏甲状腺炎的超声特征  

Ultrasonic features of Hashimoto's thyroiditis in different clinical types

作　　者：王艳滨[1] 王帅[1] 孙萌[1] 刘洋[1] 刘水澎[1] 孙冬梅[1] 

机构地区：[1]华北煤炭医学院附属医院超声科,河北唐山063000

出　　处：《中国临床医学影像杂志》2009年第11期819-822,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨桥本氏甲状腺炎(HT)不同甲状腺功能状态下的超声声像图特征。方法:选取经临床确诊的71例HT患者,按甲状腺功能分3组,HT甲亢组26例,HT甲减组24例,HT甲功正常组21例,同期选取健康查体者27例作为正常对照组对其进行超声检查,应用二维条件测量甲状腺的大小及甲状腺上动脉的血管内径,同时观察实质回声的特征,用彩色多普勒观察实质的血流分布情况,用频谱多普勒测量甲状腺上动脉的收缩期峰值流速(PSV),舒张末期流速(EDV)及阻力指数(RI)。并分析甲状腺功能与上述观察指标之间的联系。结果:①3组HT患者甲状腺侧叶的宽径、厚径和峡部的厚径均较正常组数值增大,其中侧叶的厚径在各组间的差异均有显著性,HT甲亢组甲状腺侧叶的长径较其他组增大。②HT甲亢组及HT甲功正常组的实质回声以弥漫性减低、局限性片状减低为主,HT甲减组的实质回声以弥漫性减低伴纤维条索样强回声和结节样的回声改变为主。③实质内血流的分布范围在各组间均有差异,桥本甲功正常组的实质血流以0级、Ⅰ级为主,桥本甲减组以Ⅰ级、Ⅱ级血流信号为主,桥本甲亢组的实质血流以Ⅱ级、Ⅲ级为主。④甲状腺上动脉的PSV测值在各组间均有差异;3组HT患者的RI测值均较正常者增高,但3组间差异无显著性。⑤HT甲减时,甲状腺上动脉收缩期流速与促甲状腺激素水平呈正相关(P<0.05)。结论:超声在一定程度上可用于HT甲状腺功能的评价。Objective：To evaluate the ultrasonic features of Hashimoto＇s thyroiditis（HT） with different thyroid functions.Methods：Ultrasonography was performed in 71 patients who were diagnosed as having HT.The patients were classified into three groups,the first group consisted of 26 patients with hyperthyroidism,the second group consisted of 24 patients with hy-pothyroidism and the third group consisted of 21 patients with euthyroidism.Ultrasonography（Philips,IU-22,America） was performed using high-frequency lineararray transducer（5～12MHz）.The magnitude of thyroid gland and the diameter of superior thyroid arteries（STA）,the sonographic features of thyroid gland were evaluated by gray scale sonography;subsequently color Doppler flow imaging（CDFI） was used to measure the peak systolic velocity（PSV）,end of diastolic velocity（EDV） and resistance index（RI） of STA.Results：①The width,thickness of the lateral lobe and the thickness of the isthmic portion in three HT groups were greater than those in the normal control.There was a significant difference（P〈0.05） between the thicknesses of the gland in each group.The length in the HT hyperthyroidism group was greater than that in the others.②Focal hypoechoic pattern and diffuse hypoechoic pattern were mainly seen in the groups of HT hyperthyroidism and HT euthyroidism,diffuse hypoechoic pattern with heterogeneous linear hyperechoic and nodular changes were mainly seen in the HT hypothyroidism group.③Normal subjects had CDFI pattern 0（absent or minimal intraparenchymal spots）.Patients with HT euthyroidism had CDFI pattern 0 and pattern Ⅰ（presence of parenchymal blood flow with patchy uneven distribution）.Patients with HT hypothyroidism had CDFI pattern Ⅰ and pattern Ⅱ（mild increase of color flow Doppler signal） except two cases no blood signal.Patients with HT hyperthyroidism had CDFI pattern Ⅱ and pattern Ⅲ（marked increase）.④There was a significant difference（P〈0.05） between the PSV of the STA in

关 键 词：甲状腺炎 自身免疫性 超声检查 

分 类 号：R581.4[医药卫生—内分泌] R445.1[医药卫生—内科学]