摘要
目的 探讨彩色多普勒超声在诊断甲状腺功能异常以及在鉴别诊断中的价值。方法 经专科及放射免疫测定确诊的 2 5 5例甲状腺功能异常患者 (其中原发性甲状腺功能亢进 181例 ,亚临床甲状腺功能减低 74例 ) ,对其甲状腺的二维及彩色多普勒超声表现以及甲状腺上动脉的血流参数 (收缩期峰值流速 Vmax,阻力指数RI和心率 HR)进行观察分析。结果 (1)甲亢组与亚甲减组甲状腺多有不同程度增大 ,内部回声增粗 ,光点稀疏 ,甲状腺内部血流信号明显增多 ,可呈“火海征”;(2 )所有患者的甲状腺上动脉 Vmax均明显加快 ,且甲亢组高于亚甲减组 (P<0 .0 1) ,但两组间数据重叠较多 ;(3)两组间 RI无显著性差异 (P>0 .1) ;(4)甲亢组心率值明显高于亚甲减组 (P<0 .0 0 1)。结论 甲亢和亚甲减的二维及彩色多普勒血流图表现存在较多相似点 ,甲状腺上动脉 Vmax值虽有差异 ,但存在较大的交叉范围 ,仅凭以上三项超声指标很难进行鉴别诊断 ;由于两者间心率存在非常显著差异 ,因此综合分析以上四项超声指标能明显提高超声在甲状腺功能异常方面诊断与鉴别诊断中的临床应用价值。
Objective To explore the clinical applied value of color Doppler flow imaging(CDFI) in diagnosis and differential diagnosis of hyperthyroidism (HT) and subclinical hypothyroidism (SHT).Methods A total of 181 patients with HT and 74 patients with SHT were diagnosed in clinic and confirmed by laboratory examinations.2-D and CDFI were demonstrated and flow parameters of superior thyroid artery such as systolic blood flow velocity (Vmax ),resistance index (RI) and heart rate (HR)were measured and analysed.Results (1) All thyroids of HT and SHT were enlarged with rough echoes and abundant color blood flow signals of “flame” type on CDFI.(2) The value of Vmax was significantly increased in all patients,and the Vmax of HT patients was more increased than that of SHT patients(P<0.01).(3) The value of RI had no significant difference in HT and SHT patients (P>0.1).④ The HR value of HT was significantly higher than that of SHT (P<0.001).Conclusions It is difficult to make differential diagnosis between HT and SHT with 2-D color Doppler sonography and Vmax in superior thyroid artery,but the HR variance can be used as assessional reference combined with the above 4 items for making differential diagnosis between them.
出处
《中国超声诊断杂志》
2004年第12期897-900,共4页
Chinese Journal of Ultrasound Diagnosis
