The Research Of The Usage Of High Frequency Ultrasonography In Diagnosis Of Chronic Lymphocytic Thyroiditis

Chronic lymphocytic thyroiditis,(CTL),also known as Hashimoto's disease(HT),is a kind of interstitial lymphocytic infiltration of the thyroid pathological features of chronic inflammatory autoimmune thyroid disease.It is the most common thyroid disease. The incidence of HT increased gradually in recent years.It had reported that thyroid cancer sometimes resulted from HT malignant transformation,some scholars believe that HT belongs to precancerous lesion.However,the clinical HT is often coexist with other thyroid diseases, such as thyroid adenoma, thyroid cancer, nodular goiter。Its clinical manifestations are diverse and complex that leads to misdiagnosis, wrong treatment and underwent surgical treatment. How to improve the diagnostic rate of HT and reduce the misdiagnosis rate is the goal of many researchers. This study uses high frequency ultrasonography for ultrasound images of HT to create a new objective diagnostic criteria,in order to improve the diagnosis rate, reducing misdiagnosis HT.Objective: To use high frequency ultrasonography for ultrasound images of HT to create a new objective diagnostic criteria, in order to improve the diagnosis rate, reducing misdiagnosis HT.Methods: From December 2008 to January 2010,150 cases of HT were diagnosed by high frequency ultrasound, and confirmed by surgery or biopsy.150 cases were conducted thyroid endocrine function test.The normal control group of 50 female cases was used as a comparative study. Using the American GE Logiq7 type ultrasound diagnostic instrument,Conventional examinate bilateral thyroid lobes and isthmus and observe thyroid size, shape and internal echoes.Adopt a retrospective analysis of clinical characteristics of each group, including general information, assistant examination and so on.Results: 1,High-frequency ultrasound and pathological control study found that although HT ultrasonographic varied, but not disorderly to follow. Therefore,150 patients with HT were divided into six types according to the High-frequency ultrasound and pathology:type①,Glands rough pattern;type②,Diffuse scattered micronodulars pattern;type③Diffuse medium nodulars pattern;type④,Large flake echo reduce pattern;type⑤. Scattered large nodules with glandular echo reduce pattern.type⑥Diffuse hypoechoic pattern.2,In this study,the disease is 7.82 times as frequent in women as in men,more common in young and middle-aged.HT male patients are more common in Diffuse scattered micronodulars pattern and Large flake echo reduce pattern.Female patients were found in all types.Diffuse scattered micronodulars pattern in the male to female ratio was 1:4.25, Large flake echo reduce pattern in the male to female ratio was 1:6.60.TheX2 test showed the two groups P = 0.4434 (p> 0.05), the sex ratio was no significant difference.HT 6 group among the groups <30 years old 30 to-50 age group and> 50 years the number of cases with significant differences(P<0.05),Glands rough pattern,Diffuse scattered micronodulars pattern,Diffuse medium nodulars pattern,Large flake echo reduce pattern,Diffuse hypoechoic pattern are the most common in age group 30-50, and Scattered large nodules with glandular echo reduce pattern are the most common in age over 50 years of age group. Scattered large nodules with glandular echo reduce pattern of the average age is too large, but aftert examination showed Glands rough pattern and Scattered large nodules with glandular echo reduce pattern (P = 0.024), Diffuse scattered micronodulars pattern with Scattered large nodules with glandular echo reduce pattern (P = 0.014) in the age distribution of significant differences between other groups in the age distribution was no significant difference.3. Glands rough pattern,Diffuse scattered micronodulars pattern between the normal control group in the thickening of the thyroid glands was no significant difference . Diffuse medium nodulars pattern,Large flake echo reduce pattern;Scattered large nodules with glandular echo reduce pattern,Diffuse hypoechoic pattern.were thickening of the thyroid gland, thickening rate:Scattered large nodules with glandular echo reduce pattern>Large flake echo reduce pattern>Diffuse hypoechoic pattern>Diffuse medium nodulars pattern,54 cases of which isthmus thickened.4, Diffuse medium nodules and other groups in the situation in the TGA and TMA were detected a significant difference, P <0.05. Diffuse nodulars to TGA, TMA mostly positive; Large flake echo reduce pattern and Diffuse hypoechoic pattern were significant differences(P = 0.041).Large flake echo reduce pattern compared to Diffuse hypoechoic pattern witn TGA, TMA-negative rate was more High. Otherwise comparisons of each type had no significant difference,P>0.05.Glands rough pattern,Diffuse scattered micronodulars pattern,Scattered large nodules with glandular echo reduce pattern and Diffuse hypoechoic pattern TGA, TMA mostly negative; Large flake echo reduce pattern TGA, TMA positive and negative patients with similar proportion.In 150 HT cases, 47 cases with thyroid cancer. In the 47 patients, TSH increased about 1 / 3, no TSH lower case. only a few cases FT3,FT4,TT4 are reduced,TT3 were within normal range, no FT3, FT4, TT3, TT4 increased cases.5,Every of HT can be combined with thyroid adenoma, thyroid cancer, nodular goiter。Glands rough pattern with thyroid cancer is higher than other types,however, Diffuse scattered micronodulars pattern,Diffuse medium nodulars pattern,Large flake echo reduce pattern,Scattered large nodules with glandular echo reduce pattern with nodular goiter are higher than other types; In Glands rough pattern,Diffuse scattered micronodulars pattern and Diffuse hypoechoic pattern,a few cases are concomitant of nodular goiter and thyroid cancer.Conclusions:1.150 patients with HT were divided into six types: type①,Glands rough pattern ; type②,Diffuse scattered micronodulars pattern;type③Diffuse medium nodulars pattern;type④,Large flake echo reduce pattern;type⑤. Scattered large nodules with glandular echo reduce pattern.type⑥Diffuse hypoechoic pattern. 2,In this study,the disease is 7.82 times as frequent in women as in men,more common in young and middle-aged.HT male patients are more common in Diffuse scattered micronodulars pattern and Large flake echo reduce pattern.Female patients were found in all types,Scattered large nodules with glandular echo reduce pattern of the average age is too large.3.Diffuse medium nodulars pattern,Large flake echo reduce pattern;Scattered large nodules with glandular echo reduce pattern,Diffuse hypoechoic pattern.were thickening of the thyroid gland, thickening rate:Scattered large nodules with glandular echo reduce pattern>Large flake echo reduce pattern>Diffuse hypoechoic pattern>Diffuse medium nodulars pattern.4, Diffuse nodulars to TGA, TMA mostly positive;Glands rough pattern,Diffuse scattered micronodulars pattern,Scattered large nodules with glandular echo reduce pattern and Diffuse hypoechoic pattern TGA, TMA mostly negative; Large flake echo reduce pattern TGA, TMA positive and negative patients with similar proportion.5,Every of HT can be combined with thyroid adenoma, thyroid cancer, nodular goiter。Glands rough pattern with thyroid cancer is higher than other types,however, Diffuse scattered micronodulars pattern,Diffuse medium nodulars pattern,Large flake echo reduce pattern,Scattered large nodules with glandular echo reduce pattern with nodular goiter are higher than other types;...