CAJ | 학술논문

目的探讨血流面积比技术对桥本甲状腺炎(HT)不同甲状腺功能状态的鉴别诊断价值.方法选取HT患者104例为病例组,根据甲状腺功能检查结果分为HT甲亢组、HT甲功正常组、HT甲减组,选取同期健康体检者32例为对照组,均行超声检查并用Qanalysis软件分析得到5个血流面积比参数,比较各组间的差异.结果 ①血流平均比、峰值比、谷值比在各组间比较差异均有统计学意义(P＜0.001),达峰时间与达谷时间在各组间比较差异均无统计学意义;②HT甲亢组与HT甲功正常组、HT甲功正常组与HT甲减组根据血流平均比绘制ROC曲线,以血流平均比≥0.235作为诊断HT甲亢与HT甲功正常的临界点敏感性与特异性之和最大,以血流平均比≥0.113作为诊断HT甲功正常与HT甲减的临界点敏感性与特异性之和最大.Bland-Altamn图显示血流面积比技术的重复性好,组内相关系数高.结论血流面积比技术能对甲状腺组织内的血流情况进行定量分析,对鉴别不同功能状态的HT和指导临床治疗具有一定价值.
목적 탐토혈류면적비기술대교본갑상선염(HT)불동갑상선공능상태적감별진단개치.방법 선취HT환자104례위병례조,근거갑상선공능검사결과분위HT갑항조、HT갑공정상조、HT갑감조,선취동기건강체검자32례위대조조,균행초성검사병용Qanalysis연건분석득도5개혈류면적비삼수,비교각조간적차이.결과 ①혈류평균비、봉치비、곡치비재각조간비교차이균유통계학의의(P＜0.001),체봉시간여체곡시간재각조간비교차이균무통계학의의;②HT갑항조여HT갑공정상조、HT갑공정상조여HT갑감조근거혈류평균비회제ROC곡선,이혈류평균비≥0.235작위진단HT갑항여HT갑공정상적림계점민감성여특이성지화최대,이혈류평균비≥0.113작위진단HT갑공정상여HT갑감적림계점민감성여특이성지화최대.Bland-Altamn도현시혈류면적비기술적중복성호,조내상관계수고.결론 혈류면적비기술능대갑상선조직내적혈류정황진행정량분석,대감별불동공능상태적HT화지도림상치료구유일정개치.
Objective To explore application value of blood flow ratio indexes in the diagnosis of Hashimoto's thyroiditis(HT) with different thyroid functions.Methods One hundred and four patients who were diagnosed clinically as HT were enrolled in the study.The patients were classified into three groups according to thyroid functions:the hyperthyroidism group,the hypothyroidism group and the euthyroidism group.Thirty-two volunteers with normal thyroid functions were enrolled as control group.All the cases were examined with ultrasound and five blood flow ratio indexes were calculated automatically.Their differences in the four groups were compared.Results ①Among the five blood flow ratio indexes,three indexes(mean ratio,maxratio and minratio) had significant differences between each two groups(P ＜ 0.001),the other two indexes didn't have any differences among the four groups.②Two receiver operating characteristic (ROC) curves on meanratio were drew:a)HT with hyperthyroidism and HT with euthyroidism;b) HT with euthyroidism and HT with hypothyroidism.The cutoff value as a result of the ROC analysis of HT with hyperthyroidism and HT with euthyroidism was 0.235 with the maxim of specificity and sensitivity.The cutoff value of HT with euthyroidism and HT with hypothyroidism was 0.113 with the maxim of specificity and sensitivity.Both Bland-Altamn scatter diagrams and high intraclass correlation coefficient(ICC) showed that blood flow ratio indexes have high repeatability.Conclusions Blood flow ratio indexes are promising quantitative indexes in reflecting the vascularity of thyroid parenchyma,and they are helpful in the differential diagnosis of HT with different thyroid functions.