三维彩色多普勒超声在甲状腺功能亢进症诊断中的应用

doi:10.13481/j.1671-587x.20160336

摘要/Abstract

摘要：

目的: 探讨正常甲状腺与甲状腺功能亢进症(Graves病)患者甲状腺腺体内血流和血管变化情况,阐明三维彩色多普勒超声定量诊断Graves病患者甲状腺血流的价值。方法: 选取55例Graves病患者作为病例组,38例健康志愿者作为对照组,全部受检者行甲状腺三维超声检查。使用QLAB软件系统对存储的图像进行三维重建,获得血管指数(VI)、血流指数(FI)和血管血流指数(VFI)参数。Pearson相关分析法分析病例组患者甲状腺VI、FI、VFI与甲状腺功能指标游离三碘甲状腺原氨酸(FT₃)、血清游离甲状腺素(FT₄)、促甲状腺激素(TSH)及24小时吸碘率最高值的相关性。结果: 病例组患者甲状腺两侧叶对应同部位VI、FI和VFI比较差异无统计学意义(P>0.05);病例组患者甲状腺同侧叶腺体对应部位VI、FI和VFI比较差异无统计学意义(P>0.05),病例组患者同侧叶甲状腺腺体VI、FI和VFI高于对照组(P<0.01);病例组患者左叶甲状腺VI、FI、VFI与FT₃呈正相关关系(r=0.65,r=0.34,r=0.65,P<0.05或P<0.01);病例组患者左叶甲状腺VI、FI、VFI与FT₄呈正相关关系(r=0.45,r=0.47,r=0.46,P<0.05);病例组患者左叶甲状腺VI、VFI与TSH呈负相关关系(r=-0.51、r=-0.54,P<0.05),FI与TSH无相关关系(r=-0.31,P>0.05);病例组患者左叶甲状腺VI、FI、VFI与24小时吸碘率最高值呈正相关关系(r=0.67,r=0.68,r=0.69,P<0.05)。结论: 三维彩色多普勒超声可直观、立体和定量地评价Graves病患者甲状腺血流变化情况,Graves病患者甲状腺腺体内血流弥漫性增多。

关键词: 三维超声, Graves病, 血管指数, 血流指数, 血管血流指数

Abstract:

Objective: To discuss the changes of blood flow and blood vessels of the patients with hyperthyroidism(Graves disease),and to clarify the value of three-dimensional color Doppler ultrasound in quantitative diagnosis of blood flow in the thyroid gland of the patients with Graves disease. Methods: A total of 55 cases of Graves disease (case group)and 38 cases of healthy volunteers (control group)were selected and all the subjects were examined with three-dimensional ultrasound. QLAB software was used to rebuild the storage images with three-dimensional for calculating vascular index (VI),flow index (FI),and vascular flow index (VFI).Pearson correlation analysis was used to analyze the relationships between VI,FI,VFI in thyroid and the thyroid function indexes three free iodine thyroid original amino acid(FT₃),serum free thyroxine(FT₄),thyroid stimulating hormone(TSH)and the highest value of 24-hour iodine absorption rate of the patients in case group. Results: The differences of VI,FI,and VFI on the corresponding part of both sides of thyroid lobe of the patients in case group had no statistical significance (P>0.05);the differences of VI,FI,and VFI on the corresponding part of same side of thyroid lobe of the patients in case group had no statistical significance (P>0.05);the VI,FI,and VFI on the corresponding part of same side of thyroid lobe of the patients in case group were higher than those in control group(P<0.01);the VI(r= 0.65,P<0.01),FI(r=0.34,P<0.05),and VFI (r=0.65,P<0.01)in the left lobe of thyroid of the patients in case group were positively related with FT₃;the VI,FI,and VFI in the left lobe of thyroid of the patients in case group were positively related with FT₄(r=0.45,r=0.47,r=0.46,P<0.05);the VI and VFI in the left lobe of thyroid of the patients in case group were negatively related with TSH(r=-0.51,r=-0.54,P<0.05);the FI in the left lobe of thyroid of the patients in case group had no relationship with TSH(r=0.31,P> 0.05); the VI,FI,and VFI in the left lobe of thyroid of the patients in case group were positively related with the highest value of 24-hour iodine absorption rate (r=0.67,r=0.68,r=0.69,P<0.05). Conclusion: The three-dimensional color Doppler ultrasound can intuitively,stereoscopically and quantitatively evaluate the blood flow changes in thyroid of the Graves disease patients.The blood flow in thyroid of the Graves disease patients appears diffusivity increasing.

Key words: three-dimensional ultrasound, Graves disease, vascular ization index, blood flow index

中图分类号:

R445.1

闫岩, 王志远, 石卫东, 刘美含, 陈恩琪, 姜薇. 三维彩色多普勒超声在甲状腺功能亢进症诊断中的应用[J]. 吉林大学学报(医学版), 2016, 42(03): 600-604.

YAN Yan, WANG Zhiyuan, SHI Weidong, LIU Meihan, CHEN Enqi, JIANG Wei. Application of three-dimensional color Doppler ultrasound in diagnosis of hyperthyroidism[J]. Journal of Jilin University Medicine Edition, 2016, 42(03): 600-604.

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