| Objective:According to the analysis of Autoimmune Thyroiditis (Autoimmune Thyroiditis, AIT) within different types of Paratracheal Lymph Node (Paratracheal Lymph Nodes, PLNs) display rate and ultrasonography characteristics, to have a preliminary study on PLNs value of AIT ultrasound diagnosis.Methods:93cases have been studied during the analyses which include menstrual endocrinology outpatients or diagnosis of AIT inpatients from the First People s Hospital of Yun Nan Province during January2012to December2012. Moreover,32cases of clinical diagnosis of diffuse toxic goiter (Graves Disease, GD), and9cases with subacute thyroiditis and thyroid ultrasound examination,30cases normal people of thyroid function tests and thyroid autoantibodies (Thyroid Autoimmune Antibody, TAA) as control group were also considered as study cases. To observe the thyroid size and parenchymal echo characteristics; the proportion of cortex and Paratracheal lymph nodes by the number, size, shape, and aspect ratio; and to find out the distribution of blood flow in thyroid and lymph node door through observation the Color Doppler Flow Imaging (Color Doppler Flow Imagine, CDFI).Results:(1) Within group of93AIT patients, there are74cases of Hashimoto’s Thyroiditis (Hashimoto’s Thyroiditis, HT),7cases of Postpartum Thyroiditis (Postpartum, Thyroiditis, PPT),10cases of Silent Thyroiditis (Silent Thyroiditis, ST), and2cases of Atrophic Thyroiditis (Atrophic Thyroiditis, AT). During the analysis, there are51cases within the HT tracheal on both sides of the visible lymph nodes, display rate on68.9%, and13cases in the side visible lymph nodes, display rate on17.6%,10cases showed on both sides with no lymph node, display rate on13.5%; PPT tracheal on both sides of the visible lymph nodes in5cases, display rate on71.4%, the side visible lymph nodes in1cases, display rate on14.3%, there is1cases on both sides no lymph node, within14.3%display rate; ST tracheal on both sides of the visible lymph nodes in0cases, display rate on0%, the side visible lymph nodes in2cases, display rate on20%, both sides no lymph node showed8cases, within80%display rate; AT tracheal on both sides of the visible lymph nodes in0cases, display rate on0%, a side visible lymph nodes in0cases, display rate on0%, both sides no lymph node showed2cases within100%display rate.(2)32cases of GD patients, there are5cases of tracheal paravertebral visible lymph nodes, display rate on15.6%, one side with visible lymph nodes in7cases, display rate on21.9%, and20cases of both sides no lymph node showed62.5%display rate;8cases of patients with subacute thyroiditis, and7cases of tracheal paravertebral visible lymph nodes with display rate on87.5%,1case of one side visible lymph nodes, display rate on12.5%, both sides no lymph node showed0cases with0%display rate; in the normal group of paratracheal there is no display on both sides with lymph node.(3)93cases of AIT patients with different thyroid lower paratracheal lymph nodes on both sides of each index showed there is no statistical difference (P>0.05).(4) Compare with GD patients cases, AIT patients cases have more tracheal paravertebral lymph node numbers, there is a statistically significant difference in it (P<0.05), subacute thyroiditis group paratracheal lymph node number on both sides than in AIT group, there is a statistically significant difference (P<0.05), subacute thyroiditis group tracheal paravertebral lymph node number was more than GD group (P=0.001); compare these three groups, there is a statistically significant difference on blood supply (P<0.05), subacute thyroiditis group paratracheal lymph nodes leads to blood donor than AIT group, and GD group did not cause blood supply.(5) According to TPOAb positive or negative AIT, patients were divided into two groups, between these two groups there were no significant differences among paratracheal lymph node number, length, diameter, shape, aspect ratio, corticomedullary differentiation of blood supply (P>0.05).(6)21cases from93patients showed TPOAb negative,8cases of paratracheal lymph nodes on both sides, display rate on38.1%, and2cases showed one side display on9.5%,11cases of paratracheal on both sides without lymph nodes within52.4%display rate; there is no connection between the number of TPOAb antibody value and the tracheal lymph node number, and no relation with its size, there is a statistically insignificant (p>0.05).(7)93AIT cases within Hypothyroidism patients, according to the treatment of hypothyroidism, patients were divided into pre-therapy and post-treatment levothyroxine (levothyroxine, L-T4), and to observe the paratracheal lymph node of each index. Hypothyroidism post- treatment patients with tracheal paravertebral lymph node number were lower than those pre-therapy patients, there was a statistically significant difference (P<0.05); hypothyroidism before and after treatment of tracheal paravertebral lymph node size, aspect ratio, with the quality, shape, boundary of skin blood supply, the value of TPOAb showed no statistical difference (P>0.05).(8) There are9cases from93AIT patients with paratracheal lymph nodes has leads to the blood supply within9.7%display rate.Conclusion:(1) Subacute thyroiditis paratracheal lymph node number are more than AIT patients, AIT patients received lymph node number are more than GD patients, and normal paratracheal without lymph node showed patients with subacute thyroiditis, tracheal lymph node leads to blood donor more than AIT patients, patients received GD lymph node does not cause blood supply;(2) It showed on both sides with the display rate paratracheal lymph nodes can be used as a GD or AIT which caused one of the important reference indexes of hyperthyroidism;(3) Accordingly to the trachea patients ultrasonic to detect the lymph node if it has displayed and combined with ultrasound in the thyroid can help to analysis the type of inference AIT disease;(4) Beside to AIT patients’Tube showed the lymph node are mostly round, L/T<2, medulla disappeared, and normally it is more difficult to draw the blood flow;(5) The decrease the AIT patients’lymph node number can be used as hypothyroidism after L-T4replacement therapy is an observation project of the new therapeutic effect. |
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