超声弹性成像应变率比值法在甲状腺功能异常诊断中的应用研究

发布时间：2019-04-18 06:58

【摘要】：目的：以甲状腺功能亢进患者和甲状腺功能低下患者为研究对象，应用超声弹性应变率比值法，以甲状腺周围软组织为参照检测部位，检测甲状腺组织的弹性应变率，观察甲状腺功能异常患者的弹性应变率变化，进一步探讨超声弹性成像应变率比值法在甲状腺功能异常诊断上临床应用价值，为应用此项技术对甲状腺疾病的诊断研究积累资料。 方法：本研究以2013年3月至2014年2月就诊于我院内分泌科的62名甲状腺功能异常患者及26例甲状腺功能正常的健康成人为研究对象。将上述研究对象结合临床诊断及血甲状腺功能化验分为三组：甲状腺功能亢进组、甲状腺功能低下组、甲状腺功能正常对照组。对上述三组研究对象分别进行血甲状腺功能实验室检查、甲状腺超声常规二维检查、多普勒超声检查及弹性成像检查并测得弹性应变率比值。对研究对象的临床特征、甲状腺常规超声特点、甲状腺弹性应变率比值法诊断甲状腺功能异常上的准确性及灵敏性进行总结分析。 结果：1.约半数甲状腺功能亢进患者（47.1%）可表现为甲状腺增大；2.多数甲状腺功能低下患者(78.6%)甲状腺大小变化不大；3.大部分甲状腺功能异常患者血流分布增多，血流丰富程度量化值为：甲亢：1.59±0.50，甲减：0.96±0.85；4.运用超声弹性成像应变率比值法所测数值SR1mean、SR1max、SR2mean、SR2max在正常组与甲状腺功能异常组间存在差异，正常组＜甲亢组、正常组＜甲低组，差异均有统计学意义。5.SR1mean、SR1max、SR2mean、SR2max测值在甲亢组和甲低组之间存在差异，差异无统计学意义。6.绘制SR1mean、SR1max、SR2mean、SR2max值诊断甲状腺功能异常ROC曲线，确定了SR1mean、SR1max、SR2mean、SR2max各值诊断甲状腺功能异常的最佳诊断分界点值分别为：0.63、1.34、1.41、2.0。7.通过对SR1mean、SR1max、SR2mean、SR2max值在甲状腺功能异常诊断上准确性、敏感性、特异性进行比较，以SR1mean≥0.63作为分界值诊断甲状腺功能异常，其诊断的准确性、敏感性、特异性最高，分别为75%、72.6%、80.8%。 结论：1.甲状腺功能亢进患者SR值及甲状腺功能低下患者SR值均大于＞甲状腺功能正常者，差异显著，表明甲状腺功能异常患者的甲状腺组织硬度增大。2.超声弹性成像应变率比值法是一种诊断甲状腺疾病的新方法，对临床辅助诊断甲状腺功能异常有重要的意义。可将0.63作为判断甲状腺功能异常的诊断分界值，当SR1mean≥0.63时，，提示存在甲状腺功能异常的可能。3.甲状腺功能亢进患者SR值与甲状腺功能低下患者SR值差异不显著，检测SR值对鉴别两类病变可能无意义。
[Abstract]:Objective: to study the elastic strain rate of thyroid tissue in patients with hyperthyroidism and hypothyroidism using ultrasonic elastic strain rate ratio (EFR) method and soft tissue around thyroid as the reference site to detect the elastic strain rate of thyroid tissue, and to detect the elastic strain rate of thyroid tissue by ultrasonic elastic strain rate ratio method. To observe the change of elastic strain rate in patients with thyroid dysfunction, and to discuss the clinical value of ultrasonic elastic imaging strain rate ratio method in the diagnosis of thyroid dysfunction. To accumulate data for the application of this technique in the diagnosis and study of thyroid diseases. Methods: from March 2013 to February 2014, 62 patients with thyroid dysfunction and 26 healthy adults with normal thyroid function were enrolled in this study. The subjects were divided into three groups: hyperthyroidism group, hypothyroidism group and normal thyroid function control group. Blood thyroid function laboratory examination, thyroid ultrasound two-dimensional examination, Doppler ultrasound examination and elastic imaging examination were performed in the above three groups, and the elastic strain rate ratio was measured. The accuracy and sensitivity in the diagnosis of thyroid dysfunction by the thyroid elastic strain rate ratio method were summarized and analyzed, including the clinical features of the subjects, the characteristics of thyroid routine ultrasound, and the diagnostic accuracy and sensitivity of the thyroid elastic strain rate ratio method. Results: 1. About half of the patients with hyperthyroidism (47.1%) showed thyroid enlargement. Most patients with hypothyroidism (78.6%) had little change in thyroid size; 3. The blood flow distribution was increased in most of the patients with thyroid dysfunction. The quantitative value of blood flow abundance was: hyperthyroidism: 1.59 卤0.50, hypothyroidism: 0.96 卤0.85. The value of SR1mean,SR1max,SR2mean,SR2max measured by ultrasonic elastic imaging strain rate ratio method was different between normal group and abnormal thyroid function group. The difference was statistically significant in normal group < hyperthyroidism group and normal group < hypothyroidism group. 5.SR1mean, SR1max,. There was no significant difference in SR2mean,SR2max between hyperthyroidism group and hypothyroidism group. 6. The ROC curve of SR1mean,SR1max,SR2mean, SR 2max for diagnosis of thyroid dysfunction was drawn, and the optimal diagnostic boundaries of SR1mean,SR1max,SR2mean,SR2max were determined as 0.63, 1.34, 1.41 and 2.0.7, respectively. The accuracy, sensitivity and specificity of SR1mean,SR1max,SR2mean, SR 2max in the diagnosis of thyroid dysfunction were compared. The diagnostic accuracy, sensitivity and specificity of SR1mean 鈮

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