The Application Of Acoustic Radiation Force Impulse Imaging Technology In Hashimoto’s Thyroiditis

Objective: To investigate the value of acoustic radiation force impulseimaging (ARFI) in the disease progression and outcomes of Hashimoto ’sthyroiditis to provide a reference data for diagnosis and treatment ofHashimoto’s thyroiditis for clinical.Methods: January2013-November at our clinic or hospital treatedpatients clinically diagnosed80cases of Hashimoto’s thyroiditis is the casegroup, according to Hashimoto’s thyroid function were divided into groups ofHashimoto’s hyperthyroidism, Hashimoto’s euthyroidism and Hashimoto’shypothyroidism three groups, select the corresponding period in laboratorytests and ultrasound was normal in11patients as a control group. SiemensAcusonS2000using color Doppler ultrasonography,9L4linear array probe,the frequency range7-9MHz, with ARFI imaging software.Patient supine, fully exposed neck, routine thyroid horizontal, verticaland diagonal scanning, measuring the size of the thyroid gland in thetwo-dimensional gray-scale conditions, including bilateral thyroid lobediameter, wide diameter, thickness and diameter isthmus thickness todiameter, while observing the thyroid morphology, boundary and internalecho, without nodules, nodule size was measured to observe the nodules echo.Thyroid blood flow was observed in the internal color Doppler mode, andclassification. And measurement of superior thyroid artery (peak systolicvelocity, PSV) and resistance index (resistance index, RI).With the longitudinal axis of gray scale ultrasound scan of thyroid tissue,get a clear two-dimensional image, switch to the sound tissue palpationquantitative imaging (virtual touch tissue quantification, VTQ) mode, andthen the thyroid left and right lobe were divided on the pole, the extreme,extreme, were measured upper, middle and lower pole diffuse lesions (including hypoechoic areas, hyperechoic areas, mixed echo area) of shearwave velocity (shera wave velocity, SWV), each echo measurement threetimes, taking the average of the pole SWV as the echo area, and detailedrecords, try to avoid the measurement of the blood vessels within the tissue,the patient is asked to hold your breath.Analysis using SPSS17.0software, measurement data were expressed asmean±standard deviation between the two groups were compared using twoindependent samples t-test were compared among groups were comparedusing analysis of variance, count data using the chi-square test to P <0.05wasconsidered statistically significant. To the sensitivity of the vertical axis, a oneand a specificity of abscissa, the receiver operating characteristic curve (ROC)curve, calculate the area under the curve (area under the curve AUC), todetermine the shear wave velocity Hashimoto’s thyroiditis the diagnosticthreshold.Results:1A routine ultrasound examination results1.1Four groups of thyroid parenchyma echo characteristicsThe main type of Hashimoto’s hyperthyroidism group is coarseparenchyma echo, the main type of Hashimoto euthyroidism and Hashimotohypothyroidism is hypoechoic area with gridding hyperechoic.1.2Color doppler characteristics of the four groups of thyroid parenchymaDifferences between the groups of distribution of blood flow within thethyroid was statistically significant, The normal control group is0level bloodflow. Hashimoto hyperthyroidism group is given priority to with Ⅲlevelblood flow, Hashimoto euthyroidism blood flow to the main Class I, thegroup of Hashimoto hypothyroidism is given priority to with Ⅱ andⅢlevelblood flow.Differences between the groups of superior thyroid artery peak systolicvelocity of (PSV) was statistically significant, the normal control groupcompared with Hashimoto’s thyroid function hyperthyroidism group andhypothyroidism group differences were statistically significant, the PSVof Hashimoto’s hyperthyroidism group and hypothyroidism group was higherthan the normal control group. Hashimoto’s thyroid hyperthyroidism groupcompared with the euthyroidism, the difference was statistically significant,the PSV of Hashimoto’s hyperthyroidism group was higher than theeuthyroidism. Resistance index (RI) of the difference between the groups wasnot statistically significant.2Acoustic radiation force impulse imaging test results2.1The compare of SWV between different thyroid ultrasonographicThe SWV of38cases hypoechoic area with gridding hyperechoiccompared with24cases coarse thyroid parenchyma echo and18cases platelethypoechoic area and22cases normal control group, the different wasstatistically significant, and the SWV is higher than others.The platelethypoechoic area compared with the normal control group was statisticallysignificant,and the SWV was higher than the normal control group.2.2The compare of SWV between different thyroid echoAccording to ultrasonic appearance of80cases HT were classified intothree species, high-level echo, hypoecho, mixed echo, comparing the SWV ofdifferences echo there were statistical significance, hypoechoic areas andmixed areas compared with high-level echo and normal control group echo,there were statistical significance between them, the SWV of hypoechoic areasand mixed areas higher than high-level echo and normal control group echo.2.3The compare of SWV between different thyroid functionThe SWV of Hashimoto’s hyperthyroidism, Hashimoto’s euthyroidismand Hashimoto’s hypothyroidism compare with normal control group, therewere statistical significance between them, the SWV is higher than normalcontrol group. The SWV of Hashimoto’s hyperthyroidism, Hashimoto’seuthyroidism and Hashimoto’s hypothyroidism compared with eachother,therewere no statistical significance between them.2.4The compare of SWV between different blood flow under differentthyroid functionThe compare of SWV between different blood flow under different thyroid function, there were no statistical significance between them.3According to the ROC curve shows that the shear wave velocity≥2.06m/s for the best critical point on the ROC curve, sensitivity, specificity ofdiagnostic HT were90.0%and91.0%.4The correlation analysis between SWV and TSHWill hashimoto thyroiditis SWV and serum TSH correlation analysis, theresult shows that there is no correlation between the two.Conclusion:1Hashimoto’s thyroiditis different sonographic appearance and distributionof blood flow under different thyroid function were statistically significant,So the thyroid internal echo characteristics and blood flow distribution underdifferent thyroid functional status of hashimoto thyroiditis diagnosed hasimportant application value. When thyroid parenchyma blood flow signalsincreased obviously than normal thyroid blood flow signals, not easilysuggests the existence of hyperthyroidism.2ARFI technology can quantitatively evaluate the hardness of theorganization,different sonographic appearance and different echo,the SWV aredifferet, we can assess the thyroid status,progress and treatment of the diseaseby observing the size of SWV, the higher SWV, the more serious the progressand the worse prognosis. Comparing different thyroid functional status ofSWV hashimoto thyroiditis, there was no statistically significant differencebetween the groups, there is no correlation between the serum TSH and SWV,so we can not by measuring the size of the SWV of hashimoto thyroiditis toevaluate thyroid function status.3According to the ROC curve shows that the shear wave velocity≥2.06m/s for the best critical point on the ROC curve, sensitivity, specificity ofdiagnostic HT were90.0%and91.0%.