| Background: Hashimoto's thyroiditis(Hashimoto's thyroiditis, HT) is an autoimmune disease, the disease usually has no obvious symptoms, high misdiagnosis rate. In recent years, with the continuous progress of diagnostic techniques, it is found that HT clinical disease incidence rate is high, it's also the most common cause of hypothyroidism. The thyroid function of Hashimoto's hypothyroidism early no obvious symptoms, therefor the misdiagnosis rate is high, has the characteristics of Doppler ultrasound, and grasp its characteristics helps to decrease the misdiagnosis rate and rate of missed diagnosis.To investigate the value of high frequency ultrasound in diagnosising of Hashimoto's thyroiditis with hypothyroidism, in order to find and give an accurate diagnosis, reduce the misdiagnosis rate and rate of missed diagnosis. Objective:Methods: 69 cases were selected from 2014 March to 2015 admitted in our hospital 3 patients with Hashimoto's thyroiditis, thyroid ultrasound examination confirmed the diagnosis were confirmed by and has not been treated in the past 1 months, and no obvious symptoms, according to the thyroid function is divided into normal thyroid function group(control group, 25 cases), clinical thyroid hypothyroidism(hypothyroidism group, 21 cases) and subclinical hypothyroidism group(subclinical hypothyroidism group, 23 cases), were selected in our hospital 32 cases of healthy persons as control(control group). To observe the ultrasonographic and Doppler flow characteristics, analysis and comparison of the size of the thyroid gland, parenchymal echo characteristics observed, recorded by color Doppler flow features of thyroid(color Doppler flow image, CDFI), thyroid artery blood flow acceleration(acceleration, A), acceleration time(acceleration, time, AT), systolic maximum velocity(Vmax) the resistance index(resistance, index, RI) and pulsatility index(pulsatility, index, PI).Results: the normal thyroid function group, clinical hypothyroidism and subclinical hypothyroidism group thyroid length, width, thickness and radius to thickness of isthmus and the control group had significant difference(P < 0.05), subclinical hypothyroidism and subclinical hypothyroidism group of thyroid and thyroid function in the size of the normal groups there was no significant(P > 0.05), there was no significant difference between hypothyroidism group(P > 0.05). 4 cases of normal group had sonographic findings, accounting for 16%; 21 cases showed diffuse grid low echo, which behave as grid like low echo the sparse distribution of the 15 libraries, accounting for 60%; 6 cases showed low echo in the middle grid distribution, accounting for 24%. Clinical hypothyroidism thyroid trailing edge were significantly lacy lobulation signs, accounted for 100%; the diffuse low echo string band in 20 cases, accounting for 95.24%; diffuse grid low echo in 1 cases, accounting for 4.76%. Subclinical Hypothyroidism Thyroid trailing edge visible lacy in 19 cases, accounted for 82.61% of leaf signs; diffuse low echo dense grid of 21 cases, accounting for 91.30%; diffuse low echo in 2 cases, including thin belt and thin with each of 1 cases, accounting for 4.35%. The control group without the ultrasonographic changes of thyroid parenchyma, the ultrasonographic characteristics of the difference compared with the control group were statistically significant(P < 0.05).The normal group, the clinical hypothyroidism group and Subclinical Hypothyroidism Thyroid color Doppler flow imaging(CDFI) showed signs of thyroid gland increased blood flow, blood flow signal was grade II or III, while the control group, the thyroid gland without abundant blood flow signal, thyroid blood flow signals were scarce, the color signal of blood flow showed grade 0 or 1 level. There was significant difference between group CDFI and the control group(P < 0.05), but there was no significant difference between the two groups(P > 0.05). Clinical hypothyroidism and subclinical hypothyroidism group group A values, AT values were higher than those in the normal group, the difference was statistically significant(P < 0.05); the normal group, the clinical hypothyroidism and subclinical hypothyroidism of group Vmax were significantly higher than the control group, the differences were statistically significant(P < 0.05), and sub clinical hypothyroidism group clinical hypothyroidism group Vmax was higher than that of normal group, which has a significant difference(P < 0.05), but there was no significant and the clinical hypothyroidism group Vmax difference(P > 0.05). The normal group, the clinical hypothyroidism and subclinical hypothyroidism group RI values and PI values were significantly higher than those in the control group, the differences were statistically significant(P < 0.05), but there was no significant difference between groups(P > 0.05).Conclusions:1. High frequency ultrasound is sensitive to hashimoto's thyroiditis,and si helpful to the diagnosis of the bridge's thyroiditis with hypothyroidism. 2. The patients of Hashimoto's thyroiditis usually happened in women, more concentrated in the age of 30 to 55 years old, but the function of the thyroid has no significant difference with the patient's gender, age. 3. The normal thyroid function group, clinical hypothyroidism and subclinical hypothyroidism group thyroid, subclinical hypothyroidism and subclinical hypothyroidism group of thyroid and thyroid function in the size of the normal groups there was no significant 4. The thyroid diameters of Hashimoto's thyroiditis were significantly increased, Hashimoto's thyroiditis clinical Jiajian group and the clinical hypothyroidism group was significantly greater than the diameter of the thyroid and thyroid function of Hashimoto's normal. 5. Hashimoto's thyroiditis patients with CDFI showed increased blood flow in the thyroid gland, but the rich blood flow signal and the degree of thyroid hormone levels had no correlation with Vmax, RI, and PI is an important index of Hashimoto's thyroiditis thyroid function in patients, is helpful to diagnose thyroid function abnormality. |
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