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目的应用实时二维定量剪切波弹性成像技术(shear wave elastography,SWE)测定弥漫型桥本甲状腺炎(Hashimoto’s thyroiditis,HT)患者甲状腺组织的杨氏模量值,探讨不同临床分型弥漫型HT患者杨氏模量值差异。方法弥漫型HT患者136例,根据甲状腺功能分为甲状腺功能亢进41例(甲亢组),甲状腺功能正常38例(甲功正常组),亚临床甲状腺功能减退16例(亚临床甲减组),临床甲状腺功能减退41例(临床甲减组),应用实时二维定量SWE技术测定各组甲状腺组织杨氏模量值,并与100例体检健康者(对照组)进行比较;分析杨氏模量值与血清促甲状腺素(thyroid stimulating hormone,TSH)的关系。结果弥漫型HT患者杨氏模量值[(26.34±7.05)kPa]高于对照组[(19.84±4.34)kPa](P<0.05);甲亢组杨氏模量值[(20.39±4.51)kPa]与对照组比较差异无统计学意义(P>0.05);甲功正常组、亚临床甲减组、临床甲减组杨氏模量值依次增高[(24.38±3.37)、(27.51±4.02)、(33.66±5.95)kPa],与对照组比较差异均有统计学意义(P<0.01);Pearson相关分析结果显示,甲亢组、甲功正常组杨氏模量值与血清TSH无明显相关性(r=0.044,P=0.784;r=0.114,P=0.495),亚临床甲减组、临床甲减组杨氏模量值与血清TSH水平呈正相关(r=0.914,P=0.002;r=0.869,P=0.000)。结论 SWE技术可准确测定甲状腺杨氏模量值,对弥漫型HT临床分型评估有重要价值,杨氏模量值越高,病情越重。
Objective To evaluate the Young’s modulus of thyroid tissue in patients with diffuse Hashimoto’s thyroiditis (HT) by using real-time two-dimensional quantitative shear wave elastography (SWE) Differences in Young’s modulus of patients. Methods Thirty-six patients with diffuse HT were divided into 41 cases of hyperthyroidism (hyperthyroidism group), 38 cases of normal thyroid function (normal thyroid function group), 16 cases of subclinical hypothyroidism (subclinical hypothyroidism group) under thyroid function, The clinical hypothyroidism in 41 cases (clinical hypothyroidism group), using real-time two-dimensional quantitative SWE technique to determine the thyroid tissue Young’s modulus value, and with 100 cases of healthy subjects (control group) were compared; analysis of Young’s modulus Value and serum thyrotropin (thyroid stimulating hormone, TSH) relationship. Results The Young’s modulus of diffuse HT patients was (26.34 ± 7.05) kPa higher than that of the control group (19.84 ± 4.34 kPa) (P <0.05). The Young’s modulus of hyperthyroidism group was (20.39 ± 4.51) kPa (24.38 ± 3.37) and (27.51 ± 4.02) respectively in the normal thymectomy group, the subclinical hypothyroidism group and the clinical hypothyroidism group [P0.05] , (33.66 ± 5.95) kPa], respectively, which were significantly different from those of the control group (P <0.01). The results of Pearson correlation analysis showed that there was no significant correlation between Young’s modulus and serum TSH in hyperthyroidism group and normal thyroid function group (r = 0.044, P = 0.784; r = 0.114, P = 0.495). The Young’s modulus of subclinical hypothyroidism group and clinical hypothyroidism group were positively correlated with serum TSH level (r = 0.914, P = 0.002; 0.869, P = 0.000). Conclusion The SWE technique can accurately measure the Young ’s modulus of the thyroid gland. It is of great value to evaluate the clinical classification of diffuse HT. The higher the Young’ s modulus value, the heavier the disease.