| Objective: Approch the significance Of color Doppler ultrasound in the diagnosis of hyperthyroidism.Methods: Normal control group( A group): 50,male 11 and Female 39 with age of 18～54 years old. Experimental group, diagnosed untreated patients with primary hyperthyroidism in January 2007 to 2008 in January in our hospital. Hyperthyroid patients on clinical and biochemical parameters of the clinical symptoms were divided into 3 groups:Mild group(B group):50,male 12 and Female 38 with age of 20～60 years old. Moderate group(C group):50, male 9 and Female 41 with age of 13～50 years old. Severe group(D group):39, male 10 and Female 29 with age of 19～48 years old. All volunteers and patients were observed with ATL-HDI 5000 color Doppler ultrasound. The frequency of transducer was 5～12MHz, instrument settings using thyroid specific conditions. The patient's thyroid function was tested by the nuclear medicine department of our hospital. Each patient all relevant inspection was conducted on the same day. The measurements of color Doppler were personally written by the paper operation. In a quiet state, The patients admitted supine position, fully exposed the test area. At first, to check the sonographic features of thyroid and measurement the caliber of superior thyroid artery of the right lobe with conventional two-dimensional ultrasound. Applying color Doppler flow imaging(CDFI) to observe the blood flow of thyroid and the superior thyroid artery of the right lobe. Color and pulsed Doppler technology (PW)were measured superior thyroid artery on the right lobe of the thyroid was all before the 0.5～1.0cm trunk part of the hemodynamic parameters. Sampling volume diameter was 1.0～2.0mm, and the angulation between sound beam and blood flow was <60°. Measurement part of the right lobe superior thyroid artery blood flow parameters of the thyroid. The maximum velocity of systolic(Vmax), the average flow rate(Vmean), resistance index(RI), at last, use the formula Q=1/4πVD~2×60(ml/min)to compute blood flow perminute.Statistically: This study used SPSS 11.5 statistical software for analysis of the data collected. Every measurement parameter was said to the mean±standard deviation( x±s), group compared with the single-factor analysis of variance and the F-test, every two groups compared with the q test, it was a statistical significance when P <0.05.Results:1 2D ultrasonographic featuresThe thyroid of control group appearance rules, symmetrical, Internal essentially echo is homogeneous, uniform distribution, realm clear, edge realm clear rules, coated integrity. In patients with hyperthyroidism, beside the early onset, the whole enlarged thyroid generally is usually visible. Two pieces of the thyroid are increasing homogeneity of the main symmetry. More marginal rules, Internal echo is low to moderate thickening enhanced, homogeneous or inhomogeneous distribution.2 CDFI appearanceThe thyroid of control group blood flow signals within the rich, Some scattered in the internal point of the band and blood flow signals, In patients with hyperthyroidism, there are increased blood flow signals within the gland, Most showed diffuse and point-color or branch flow distribution ,Performance for the "sea of fire levies".3 blood flow frequency spectrogramThe thyroid of control group is low resistance and low velocity, In patients with hyperthyroidism, the spectrum is broadening, turbulence was kind, the volatility is increased in diastolic with high resistance and high velocity.4 Hemodynamic Parameters(D,Vmax,Vmean,RI,Q)4 .1 Diameter (D)A group,B group,C group and D group, they were compared with the single-factor analysis of variance and the F-test, every two groups compared with the q test.P<0.05, all of them have a statistical significance 4 .2 The maximum velocity of systolic (Vmax)A group,B group,C group and D group, they were compared with the single-factor analysis of variance and the F-test, every two groups compared with the q test. P<0.05, all of them have a statistical significance.4 .3 The average flow rate (Vmean)A group,B group,C group and D group, they were compared with the single-factor analysis of variance and the F-test, every two groups compared with the q test. Except B group and C group, C group and D group, P<0.05, all of them have a statistical significance. B group compare with C group, C group compare with D group, P>0.05, all of them have not a statistical significance.4 .4 The resistance index(RI)A group,B group,C group and D group, they were compared with the single-factor analysis of variance and the F-test, every two groups compared with the q test. Except A group and C group, A group and D group, C group and D group, P>0.05, all of them have not a statistical significance. A group compare with B group, B group compare with C group, B group compare with D group, P<0.05, all of them have a statistical significance.4 .5 The blood flow per minute(Q)A group,B group,C group and D group, they were compared with the single-factor analysis of variance and the F-test, every two groups compared with the q test. P<0.05, all of them have a statistical significance.Conclusion:In this paper, 2D, CDFI, a number of technology combined with PW, by using clinical observation, related laboratory tests and other practices, approached the significance Of color Doppler ultrasound in the diagnosis of hyperthyroidism and their degree by measurement the hyperthyroid patients on the right lobe of the superior thyroid artery diameter, peak systolic velocity, the average flow velocity and resistance index and blood flow changes. It shows that, in patients with hyperthyroidism, the superior thyroid artery diameter, peak systolic velocity, the average flow velocity and blood flow per minute changes are significantly different with the control group. Among the total, the superior thyroid artery diameter, peak systolic velocity and blood flow per minute changes have their determinate significance in patients with hyperthyroidism with different degree. So, through the use of traditional ultrasonic inspection techniques and color Doppler flow imaging technology, measurement the hyperthyroid patients on the right lobe of the superior thyroid artery diameter, peak systolic velocity, and use the formula Q=1/4πVD~2×60(ml/min)to compute blood flow per minute, we can provide objective, accurate information for doctors, to provide an objective basis for indexing for the diagnosis of hyperthyroidism, we can also provide reference for the treatment of hyperthyroidism. In the other hand, color Doppler ultrasound also is fast, convenient and simple, and easy to operate, no pain, and other advantages to facilitate repeat inspection. At present, the comparison of color Doppler ultrasound has been popular, it is also a non-invasive examination of the body surface, and susceptible for patients, thus it has very practical value for the diagnosis of patients with hyperthyroidism. |
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