剪切波弹性成像及二维超声双模态对桥本甲状腺炎的诊断价值  

Diagnostic Value of Shear Wave Elastography and Two-dimensional Bimodal Ultrasound in Hashimoto Thyroiditis

作　　者：郭国强[1] 李泉水 张璟 吴欣殷 关晓韵 蔡爱莲 袁伟 Guo Guoqiang;Li Quanshui;Zhang Jing;Wu Xinyin;Guan Xiaoyun;Cai Ailian;Yuan Wei(Department of Ultrasound,The Second People's Hospital of Shenzhen,Shenzhen,Guangdong 518035,China;Department of Ultrasound,The Luohu People's Hospital of Shenzhen,Shenzhen,Guangdong 518005,China)

机构地区：[1]深圳市第二人民医院超声科,广东省深圳市518035 [2]深圳市罗湖区人民医院超声科,广东省深圳市518005

出　　处：《中国超声医学杂志》2023年第7期737-741,共5页Chinese Journal of Ultrasound in Medicine

基　　金：深圳市医学重点学科(No.SZXK052)。

摘　　要：目的探讨甲状腺峡部旁淋巴结(TPLN)二维超声(2D-US)、甲状腺剪切波弹性成像(SWE)双模态对桥本甲状腺炎(HT)的诊断价值。方法回顾分析101例HT(64例病理组和37例综合组),所有病例均行实验室检查,2D-US和SWE检查;实验室检查包括TPOAb和TgAb,2D-US检查包括甲状腺回声和TPLN的数量、最大径、纵横比、内部回声,SWE检查测量甲状腺平均弹性值(mean),并以15 kPa和30 kPa为界限分三段。结果(1)101例HT中,综合组TPOAb、TgAb升高的占比大于病理组,有统计学意义(χ^(2)=12.476,P<0.05;χ^(2)=17.582,P<0.05)。(2)101例HT中,综合组典型声像图的占比大于病理组,有统计学意义(χ^(2)=29.731,P<0.05)。(3)101例HT中,综合组与病理组TPLN可显示的占比无统计学意义(χ^(2)=0.260,P>0.05)。在92例TPLN中,淋巴结多1~3个,纵横比<1,最大径3~7 mm,内部呈低回声或极低回声,内无钙化和囊性变。(4)101例HT中,mean与TPOAb值呈显著正相关(r=0.866),与TgAb值无相关(r=0.144);弹性中等(<15 kPa)者、弹性增高(15~30 kPa)者及弹性极高(>30 kPa)者分别占17.82%、67.33%、14.85%。结论HT的TPLN显示率高,HT的弹性值高,甲状腺及TPLN的2D-US结合SWE有可能提高HT的诊断率。Objective To investigate the diagnostic value of bimodal ultrasound which included two-dimensional ultrasound(2D-US)and shear wave elastography(SWE)of thyroid gland and thyroid para-isthmus lymph node(TPLN)in Hashimoto thyroiditis(HT).Methods 101 cases of HT were analyzed retrospectively(64 cases in pathological group and 37 cases in comprehensive group).All cases were examined by laboratory,2D-US and SWE.Laboratory tests included TPOAb and TgAb,2D-US examination included thyroid echo and the number,maximum diameter,aspect ratio,internal echo of TPLN,and SWE examination to measured the mean elasticity of thyroid,divided into three sections with limits of 15 kPa and 30 kPa.Results(1)Among the 101 cases of HT,the proportion of TPOAb and TgAb in the comprehensive group was higher than that in the pathological group,with statistical significance(χ^(2)=12.476,P<0.05;χ^(2)=17.582,P<0.05).(2)Among the 101 cases of HT,the proportion of typical sonograms in the comprehensive group was higher than that in the pathological group,with statistical significance(χ^(2)=29.731,P<0.05).(3)In 101 cases,there was no statistical significance in the proportion of TPLN visible between the comprehensive group and pathological group(χ^(2)=0.260,P<0.05).In 92 cases of TPLN,there were 1-3 more lymph nodes,aspect ratio 1,maximum diameter 3-7 mm,internal hypoechoic or very hypoechoic,no calcification and cystic change.(4)In 101 cases of HT,mean was positively correlated with TPOAb(r=0.866),but not with TgAb(r=0.144);Medium elasticity(less than 15 kPa),increased elasticity(15-30 kPa)and high elasticity(more than 30 kPa)accounted for 17.82%,67.33%and 14.85%,respectively.Conclusions The TPLN display rate of HT is high and the elasticity value of HT is high;thyroid and TPLN 2D-US and SWE may improve the diagnostic rate of HT.

关 键 词：二维超声 甲状腺峡部旁淋巴结 剪切波弹性成像 桥本甲状腺炎 

分 类 号：R445.1[医药卫生—影像医学与核医学] R581.4[医药卫生—诊断学]