桥本病及其合并症的超声表现  

Sonographic characteristics of Hashimoto's thyroiditis and its complications

作　　者：郑宗英[1] 林新霖[1] 柯晓刚[1] 申玉萍[1] 陈玲[1] 刘新秀[1] 甘玲[1] 

机构地区：[1]福建医科大学附属第一医院超声科,福州350005

出　　处：《中华超声影像学杂志》2002年第3期157-160,共4页Chinese Journal of Ultrasonography

摘　　要：目的　探讨桥本病及其并发症的超声表现。方法　对 70例经手术或穿刺活检证实的桥本病患者应用常规二维高频探头超声检查甲状腺大小、回声 ,部分病例进行彩色多普勒血流图及血清甲状腺内分泌水平测定 ,并与手术病理结果对照。结果　弥漫低回声型伴网格样带状高回声 2 2例 (3 1.4% ) ,弥漫小低回声结节型15例 (2 1.4% ) ,散在结节型 9例 (12 .9% )。病理上均因淋巴细胞浸润范围、分布不同和纤维组织增生的程度不同而致声像图表现有所不同。合并甲状腺瘤 14例 (2 0 .0 % ) ,甲状腺癌 6例 (8.6% ) ,其他 4例 (5 .7% )。血流丰富 2 1例 (61.8% ) ,Tg、Tm增高 3 3例 (71.7% )。血流丰富程度与T3 、T4及Tg、Tm水平无关 ,与TSH及甲状腺大小有关。结论　桥本病声像图表现有一定特异性 ,但需结合临床、甲状腺功能或穿刺活检方能提高确诊率 ,以减少不必要的手术干预。Objective To distinguish better sonographic characteristics of Hashimoto's thyroiditis (HT) and its complications.Methods Ultrasonographic characteristics of seventy patients with histologically conformed HT was observed with a 10 MHz transducer and compared with the operation and pathology.Thirty four cases of HT were examined by color Doppler flow image (CDFI),46 cases of HT serum thyroid hormone levels were determined.Results Diffusely hypoechoic nonhomogenous echopattern was found in 22 cases ( 31.4% ),numerous hypoecoic microdules in 15 ( 21.4% ),scattered small nodules in 9( 12.9% ),complications in 24 ( 34.3% ).Adenoma was commonly complicated in 14 cases pre existing HT ( 20.0% ),thyroid cancer in 6 ( 8.6% ),non Hodgkin's lymphoma one case,other complications in 3 cases.All cases showed degeneration and disappearance of thyroid follicles,lymph cells invasion in varying degrees on pathology.Marked increase of color flow signal appeared in 7( 20.6% ),medium increase in 14( 41.2% ),mild increase 13( 38.2% ).An increase in both Tg and Tm was observed in 34 cases with HT ( 71.7% ).Thyroid blood flow (TBF) was not dependent on serum T 3,T 4 and Tg,Tm elevels (P> 0.05 ),but TBF was related with serum TSH levels (P< 0.05 ).Conclusions In order to eliminate unnecessary surgical intervention,ultrasonography should be combined with serum thyroid hormones and fine needle biopsy when necessary.

关 键 词：超声检查 甲状腺炎 自身免疫性 诊断 桥本病 

分 类 号：R445.1[医药卫生—影像医学与核医学]