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目的分析甲状腺功能低下患者临床误诊的原因并探讨高频超声在诊断甲状腺功能低下患者中的意义。方法对本院2005年10月～2009年12月间36例甲状腺功能低下而临床拟诊为甲状腺腺瘤、甲状腺癌、结节性甲状腺肿或甲状腺功能亢进的惠者进行回顾性分析。结果 36例被临床误诊的甲低患者,二维超声除3例外甲状腺腺体积均有不同程度增大,尤峡部明显且回声不均匀减低,可见短线样网格状强回声。彩色多普勒表现为腺体内彩色血流丰富,本组有8例结节内可见三条以上彩色血流信号。患者左右叶腺体的甲状腺上动脉血流动力学参数间比较,差异无统计学意义。但与对照组比较,甲低患者的血流速度峰值显著高于对照组,差异有统计学意义(P<0.05),血流阻力指数RI与对照组比较,差异无统计学意义(P>0.05)。结论甲状腺功能低下患者临床表现复杂,临床医生对其应有充分的认识,应密切结合彩色多普勒超声等辅助检查,以避免误诊和漏诊。
Objective To analyze the causes of clinical misdiagnosis in patients with hypothyroidism and to explore the significance of high-frequency ultrasonography in the diagnosis of hypothyroidism. Methods From October 2005 to December 2009 in our hospital, 36 cases of hypothyroidism clinically diagnosed as thyroid adenoma, thyroid cancer, nodular goiter or hyperthyroidism beneficiaries were retrospectively analyzed. Results Thirty-six patients with hypothyroidism who were clinically misdiagnosed, the volume of thyroid gland in three cases except two-dimensional ultrasonography increased in different degrees. The isthmus was obviously and the echoes were not uniformly reduced. Color Doppler manifestations of glandular blood flow is rich in color, this group has eight cases of nodules visible more than three color flow signals. There was no significant difference in hemodynamic parameters of thyroid artery between the left and right leaf glands of patients. However, compared with the control group, the peak blood flow velocity in patients with hypothyroidism was significantly higher than that in the control group (P <0.05), and the RI of the blood flow resistance index was not significantly different from that in the control group (P> 0.05 ). Conclusions The clinical manifestations of patients with hypothyroidism are complicated. Clinicians should have adequate understanding of them and should be closely combined with color Doppler ultrasound to avoid misdiagnosis and missed diagnosis.