| Objective:To investigate clinical value of the virtual touch tissue imaging quantifica tion(VTIQ)in the diagnosis of Hashimoto thyroiditis(HT).Methods:From the July 2015 to December 2016,100 Hashimoto thyroiditis patients were diagnosed in the Fifth Hospital Affiliated to Kunming Medical University.Another 30 volunteers of who B-mode ultrasound and thyroid serology and function tests were normal as the control group.The observation group according to the thyroid function test results by the laboratory chemical immune luminescence method determination were divided into three subgroups:normal thyroid function group,subclinical hypothyroidism group and clinical hypothyroidism group.The observation group according to the B-mode ultrasound were divided into three subgroups:local echo reduction,diffuse echo reduction and diffuse echo reduction with reticular changes.All 130 subjects who underwent diagnostic ultrasound examination of the thyroid that included ARFI imaging with VTIQ at our institution.The SWV value of the abnormal thyroid tissues of the HT patients were compared with the SWV value of the normal thyroid tissues of the control group.The difference between the observation group and the control group were compared by the t test.The difference between the control group and the subgroups of the clinical stage and the ultrasonic classification in the observation group comparing by the TamhaneT2,DunnettT3 test,the difference will have statistical significance P less than 0.05 and have significant differences P less than 0.01.Analyze the correlation coefficient between the SWV value of the observation group and the clinical stage of the HT,calculate the area of the ROC curve.The peak value of the Youden index confirms the diagnostic cut-off value of SWV for diagnosing the diffuse HT(the diffuse echo reduction group and the diffuse echo reduction with reticular changes group)and the decay of the thyroid function in patients with HT,calculate respectively the sensitivity and specificity of diagnosis cut-off value.Results:(1)The mean SWV value of the abnormal thyroid tissues in observation group is(2.97±0.30)m/s,the mean SWV value of the normal thyroid tissues in control group is(2.51±0.35)m/s,the difference between of them has statistically significant(P<0.05).(2)The mean SWV value of the each subgroup of the clinical stage in the observation group:HT thyroid function normal group is(2.74±0.27)m/s(n=35),HT sub-clinical hypothyroidism group is(3.06±0.25)m/s(n=32),HT clinical hypothyroidism group is(3.14±0.22)m/s(n=33).The control group and clinical staging each subgroup pairwise comparison:The SWV value of the subclinical hypothyroidism and the clinical hypothyroidism group have no statistical significance(P>0.05);The SWV value of the other groups have statistical significance(P<0.05).(3)The mean SWV value of the each subgroup of the ultrasonic classification in the observation group:local echo reduction is(2.62±0.21m/s,n=23),diffuse echo reduction is(3.04±0.24m/s,n=47),diffuse echo reduction with reticular changes is(3.14±0.24m/s,n=30).The control group and ultrasonic classification each subgroup pairwise comparison:The SWV value of the control group and the local echo reduction control group have no statistical significance(P>0.05);The SWV value of the diffuse echo reduction group and the diffuse echo reduction with reticular changes group have no statistical significance(P>0.05);The SWV value of the other groups have statistically significant(P<0.05).(4)The correlation coefficient is 0.591(P<0.01)between the SWV value of the observation group and the clinic stage of the HT.(5)The SWV value built the ROC curve in the diagnosis of diffuse HT(the diffuse echo reduction group and the diffuse echo reduction with reticular changes group)and the decay of the thyroid function in patients with HT.The AUC of the SWV values respectively is 0.897,0.931,the diagnostic cut-off value respectively is 2.66 m/s,2.92 m/s,the sensitivity respectively is 96.1%,87.9%,the specificity respectively is 70.0%,80%.Conclusion:The mean SWV value of the abnormal thyroid tissues in the Hashimoto thyroiditis patients is higher than the mean SWV value of the normal thyroid tissue.It indicated that the stiffness of the abnormal thyroid tissues in HT is more than the normal thyroid tissue.The differences between the abnormal thyroid tissues and the normal thyroid tissue have obvious differences.The SWV value can diagnose diffuse HT(the diffuse echo reduction group and the diffuse echo reduction with reticular changes group)and the decay of the thyroid function in patients with HT by building the ROC curve.The SWV value have a certain degree of sensitivity and specificity.In conclusion,The VTIQ as a new technology of ultrasonic elastography has certain practical value for diagnosis of diffuse HT(the diffuse echo reduction group and the diffuse echo reduction with reticular changes group)and assessment of the function change of the thyroid tissue. |
PDF Full Text Request