摘要
目的探讨二维及彩色多普勒超声在桥本氏甲状腺炎与甲状腺功能亢进症鉴别诊断中的价值。方法选择在本院门诊就诊的桥本氏甲状腺炎患者与甲状腺功能亢进症患者各30例,分别为桥本组与甲亢组,同时选择30例正常检查者为对照组。所有患者均采用超声检査,观察患者甲状腺大小、形态及回声,测量各组甲状腺上动脉收缩期峰值流速(PSV)、舒张末期流速(EDV)及血流阻力指数(RI),比较并分析观察指标与疾病之间的联系。结果对照组二维超声检查表现为两侧甲状腺大小对称,峡部厚度适中,形态规则,边界清晰,腺体内部回声均匀,彩色多普勒超声示甲状腺内可见点状或条索状血流信号。桥本组患者二维超声表现甲状腺增厚以峡部为主,腺体内部可见分隔状或网格样强回声,两侧颈部可见肿大淋巴结,彩色多普勒超声常可见增多血流信号。甲亢组患者二维超声表现甲状腺常呈弥漫性肿大,腺体内部回声可增粗或减低,彩色多普勒超声可见丰富血流信号,呈"火海征"。桥本组及甲亢组患者甲状腺上动脉PSV、EDV均较对照组增快(P<0.05或P<0.01),且甲亢组增快更为明显(P<0.05),三组患者甲状腺上动脉RI值两两比较无明显统计学差异(P>0.05)。结论通过二维超声、彩色多普勒超声表现及甲状腺上动脉频谱参数甲状腺上动脉PSV、EDV综合比较,能简便、快速、准确地鉴别桥本氏甲状腺炎与甲状腺功能亢进症,为临床的诊断与治疗提供依据。
Objective To investigate the value of two-dimensional and color Doppler ultrasonography in the differential diagnosis of Hashimoto＇s thyroiditis and hyperthyroidism.Methods 30 patients with Hashimoto＇s thyroiditis and 30 cases with hyperthyroidism who were admitted to the outpatient clinic in our hospital were selected and divided into Hashimoto group and hyperthyroid group.At the same time,30 normal subjects were selected as the control group.All patients were examined by ultrasonography.The thyroid size,shape and echo were observed.The peak systolic velocity（PSV）,end diastolic velocity（EDV） and blood flow resistance index（RI） of the superior thyroid artery were measured in each group.The correlations between the observed indicators and the disease were compared and analyzed.Results The two-dimensional ultrasonography in the control group showed symmetrical size of the bilaterial thyroid gland,moderate thickness of the isthmus,regular shape,clear boundary,and uniform gland internal echo.Color Doppler ultrasonography showed point-like or cord-like blood flow signals in thyroid gland.Two-dimensional ultrasound in the patients in Hashimoto group showed thickening of the thyroid gland,mainly around the isthmus.Separation-like or grid-like strong echoes were observed inside the gland.Enlarged lymph nodes could be palpated at bilateral necks.Color Doppler ultrasound were often with increased blood flow signal.Diffuse enlargement of the thyroid was often seen by two-dimensional ultrasound in the patients in hyperthyroidism group.Gland internal echo could be thickened or reduced.Color Doppler ultrasound showed rich blood flow signal,like ＂fire sea sign＂.PSV and EDV in the upper thyroid artery in the Hashimoto group and hyperthyroidism group were both increased than those in the control group（P〈0.05 or P〈0.01）,and the increase in the hyperthyroidism group was more significant（P〈0.05）.There was no statistically significant difference of RI of the upper thyroid artery between the three groups（P〉0.05）.Conclusion By the comprehensive comparison of the findings of two-dimensional ultrasonography and color Doppler ultrasonography,as well as upper thyroid artery parameters,and upper thyroid artery PSV and EDV,Hashimoto＇s thyroiditis and hyperthyroidism can be differentiated easily,quickly and accurately,which provides references for the clinical diagnosis and treatment.
出处
《中国现代医生》
2017年第1期111-113,共3页
China Modern Doctor
关键词
超声
桥本氏甲状腺炎
甲状腺功能亢进
鉴别
Ultrasonography
Hashimoto＇s thyroiditis
Hyperthyroidism
Differentiation
