局限性桥本氏甲状腺炎的超声影像学特征  

Sonographic Features of Focal Hashimoto's Thyroiditis

作　　者：傅先水[1,2] 李志强[1] 张华斌[1] 王金锐[1] 

机构地区：[1]北京大学第三医院超声科,北京100191 [2]中国人民解放军总医院第一附属医院超声科,北京100048

出　　处：《中国医学科学院学报》2014年第3期291-295,共5页Acta Academiae Medicinae Sinicae

摘　　要：目的探讨灰阶及彩色多普勒超声对局限性桥本氏甲状腺炎(FHT)的诊断价值。方法回顾性分析2006年12月至2013年10月经手术或粗针穿刺病理证实的120例FHT患者的120个结节的灰阶及彩色多普勒声像图,将结节周围的甲状腺实质背景分为正常和弥漫性桥本氏甲状腺炎两种,将结节内的血流分为乏血供型、中心血流型、周边血流型、限局性火海征型4种类型。结果 120个FHT结节中,59.2%(71/120)发生于正常甲状腺背景,40.8%(49/120)发生于弥漫性桥本氏甲状腺炎背景。正常甲状腺背景下,85.9%(61/71)的结节为低回声,14.1%(10/71)为等回声或高回声;弥漫性桥本氏甲状腺炎背景下,40.8%(20/49)的结节为低回声,59.2%(29/49)为等回声或高回声,差异有统计学意义(P<0.001)。结节的4种血流类型中,乏血供型、中心血流型、周边血流型和局限性火海征型的比例分别为45.0%、25.9%、20.8%和8.3%。结论局限性火海征是FHT的比较特异性的彩色多普勒超声表现。Objective To evaluate the diagnostic values of gray-scale and color Doppler ultrasound in the diagnosis of focal Hashimoto＇ s thyroiditis （FHT）.Methods The gray-scale and colour Doppler ultrasound data of 120 patients with histopathologically confirmed FHT were retrospectively studied.The background of thyroid parenchyma was subjectively evaluated as absence or presence of diffuse Hashimoto＇ s thyroiditis.The vascular types of thyroid nodules were determined as follows：hypovascularity,marked internal flow,marked peripheral flow,and focal thyroid inferno.Results Among all 120 nodules,71 （59.2％） were located in normal thyroid parenchyma,49 （40.8％） in the background of diffuse Hashimoto＇ s thyroiditis.In the normal thyroid background,hypoechoic nodules accounted for 85.9％ （61/71）,and only 14.1％ （10/71） nodules were isoechoic or hyperechoic.However,in the background of diffuse Hashimoto＇ s thyroiditis,40.8％ were hypoechoic and 59.2％ were isoechoic or hyperechoic.The difference was statistically significant （P ＜ 0.001）.In terms of the vascular types,the hypovascularity,marked internal flow,marked peripheral flow,and focal thyroid inferno accounted for 45 ％,25.9％,20.8％,and 8.3％,respectively.Conclusion The ＂focal inferno＂ is a relative specific color Doppler feature of FHT.

关 键 词：局限性 桥本氏甲状腺炎 火海征 超声 

分 类 号：R445.1[医药卫生—影像医学与核医学]