【摘要】：目的：以甲狀腺功能亢進(jìn)患者和甲狀腺功能低下患者為研究對象，應(yīng)用超聲彈性應(yīng)變率比值法，以甲狀腺周圍軟組織為參照檢測部位，檢測甲狀腺組織的彈性應(yīng)變率，觀察甲狀腺功能異�；颊叩膹椥詰�(yīng)變率變化，進(jìn)一步探討超聲彈性成像應(yīng)變率比值法在甲狀腺功能異常診斷上臨床應(yīng)用價(jià)值，為應(yīng)用此項(xiàng)技術(shù)對甲狀腺疾病的診斷研究積累資料。 方法：本研究以2013年3月至2014年2月就診于我院內(nèi)分泌科的62名甲狀腺功能異�；颊呒�26例甲狀腺功能正常的健康成人為研究對象。將上述研究對象結(jié)合臨床診斷及血甲狀腺功能化驗(yàn)分為三組：甲狀腺功能亢進(jìn)組、甲狀腺功能低下組、甲狀腺功能正常對照組。對上述三組研究對象分別進(jìn)行血甲狀腺功能實(shí)驗(yàn)室檢查、甲狀腺超聲常規(guī)二維檢查、多普勒超聲檢查及彈性成像檢查并測得彈性應(yīng)變率比值。對研究對象的臨床特征、甲狀腺常規(guī)超聲特點(diǎn)、甲狀腺彈性應(yīng)變率比值法診斷甲狀腺功能異常上的準(zhǔn)確性及靈敏性進(jìn)行總結(jié)分析。 結(jié)果：1.約半數(shù)甲狀腺功能亢進(jìn)患者（47.1%）可表現(xiàn)為甲狀腺增大；2.多數(shù)甲狀腺功能低下患者(78.6%)甲狀腺大小變化不大；3.大部分甲狀腺功能異常患者血流分布增多，血流豐富程度量化值為：甲亢：1.59±0.50，甲減：0.96±0.85；4.運(yùn)用超聲彈性成像應(yīng)變率比值法所測數(shù)值SR1mean、SR1max、SR2mean、SR2max在正常組與甲狀腺功能異常組間存在差異，正常組＜甲亢組、正常組＜甲低組，差異均有統(tǒng)計(jì)學(xué)意義。5.SR1mean、SR1max、SR2mean、SR2max測值在甲亢組和甲低組之間存在差異，差異無統(tǒng)計(jì)學(xué)意義。6.繪制SR1mean、SR1max、SR2mean、SR2max值診斷甲狀腺功能異常ROC曲線，確定了SR1mean、SR1max、SR2mean、SR2max各值診斷甲狀腺功能異常的最佳診斷分界點(diǎn)值分別為：0.63、1.34、1.41、2.0。7.通過對SR1mean、SR1max、SR2mean、SR2max值在甲狀腺功能異常診斷上準(zhǔn)確性、敏感性、特異性進(jìn)行比較，以SR1mean≥0.63作為分界值診斷甲狀腺功能異常，其診斷的準(zhǔn)確性、敏感性、特異性最高，分別為75%、72.6%、80.8%。 結(jié)論：1.甲狀腺功能亢進(jìn)患者SR值及甲狀腺功能低下患者SR值均大于＞甲狀腺功能正常者，差異顯著，表明甲狀腺功能異�；颊叩募谞钕俳M織硬度增大。2.超聲彈性成像應(yīng)變率比值法是一種診斷甲狀腺疾病的新方法，對臨床輔助診斷甲狀腺功能異常有重要的意義�？蓪�0.63作為判斷甲狀腺功能異常的診斷分界值，當(dāng)SR1mean≥0.63時(shí)，，提示存在甲狀腺功能異常的可能。3.甲狀腺功能亢進(jìn)患者SR值與甲狀腺功能低下患者SR值差異不顯著，檢測SR值對鑒別兩類病變可能無意義。
[Abstract]:Objective: to study the elastic strain rate of thyroid tissue in patients with hyperthyroidism and hypothyroidism using ultrasonic elastic strain rate ratio (EFR) method and soft tissue around thyroid as the reference site to detect the elastic strain rate of thyroid tissue, and to detect the elastic strain rate of thyroid tissue by ultrasonic elastic strain rate ratio method. To observe the change of elastic strain rate in patients with thyroid dysfunction, and to discuss the clinical value of ultrasonic elastic imaging strain rate ratio method in the diagnosis of thyroid dysfunction. To accumulate data for the application of this technique in the diagnosis and study of thyroid diseases. Methods: from March 2013 to February 2014, 62 patients with thyroid dysfunction and 26 healthy adults with normal thyroid function were enrolled in this study. The subjects were divided into three groups: hyperthyroidism group, hypothyroidism group and normal thyroid function control group. Blood thyroid function laboratory examination, thyroid ultrasound two-dimensional examination, Doppler ultrasound examination and elastic imaging examination were performed in the above three groups, and the elastic strain rate ratio was measured. The accuracy and sensitivity in the diagnosis of thyroid dysfunction by the thyroid elastic strain rate ratio method were summarized and analyzed, including the clinical features of the subjects, the characteristics of thyroid routine ultrasound, and the diagnostic accuracy and sensitivity of the thyroid elastic strain rate ratio method. Results: 1. About half of the patients with hyperthyroidism (47.1%) showed thyroid enlargement. Most patients with hypothyroidism (78.6%) had little change in thyroid size; 3. The blood flow distribution was increased in most of the patients with thyroid dysfunction. The quantitative value of blood flow abundance was: hyperthyroidism: 1.59 鹵0.50, hypothyroidism: 0.96 鹵0.85. The value of SR1mean,SR1max,SR2mean,SR2max measured by ultrasonic elastic imaging strain rate ratio method was different between normal group and abnormal thyroid function group. The difference was statistically significant in normal group < hyperthyroidism group and normal group < hypothyroidism group. 5.SR1mean, SR1max,. There was no significant difference in SR2mean,SR2max between hyperthyroidism group and hypothyroidism group. 6. The ROC curve of SR1mean,SR1max,SR2mean, SR 2max for diagnosis of thyroid dysfunction was drawn, and the optimal diagnostic boundaries of SR1mean,SR1max,SR2mean,SR2max were determined as 0.63, 1.34, 1.41 and 2.0.7, respectively. The accuracy, sensitivity and specificity of SR1mean,SR1max,SR2mean, SR 2max in the diagnosis of thyroid dysfunction were compared. The diagnostic accuracy, sensitivity and specificity of SR1mean 鈮

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