目的 探讨剪切波弹性成像（shear wave elastography,SWE）联合全息血管硬度分析（holographic vascular hardness analysis,R-VQS）技术在桥本氏甲状腺炎诊断中的应用价值。方法 选择2022年7月至2023年7月在我院就诊的新发桥本氏甲状腺炎（Hashimoto's thyroiditis,HT）或未接受过抗甲状腺药物治疗的既往HT女性患者共70例。健康对照组为同期在我院体检的年龄匹配的30名健康女性。70例HT患者按甲状腺功能（简称甲功）正常与否分为甲功异常HT组56例和甲功正常HT组14例。比较三组总胆固醇（total cholesterol,TC）、甘油三酯（triglyceride,TG）、低密度脂蛋白胆固醇（low-density lipoprotein cholesterol,LDL-C）、甲状腺球蛋白抗体（thyroglobulin antibody,TgAb）颈动脉内-中膜厚度（carotid intima-media thickness,IMT）、颈动脉脉搏波传导速度（carotid artery pulse wave velocity,PWV）、硬度指数（stiffness index,SI）、右颈总动脉收缩期直径（systolic diameter,SD）、血管壁位移（vascular wall displacement,VWD）、杨氏模量值,通过ROC分析杨氏模量值诊断HT患者的价值。结果 三组TC、TG、TgAb水平比较,健康对照组<甲功正常HT组<甲功异常HT组;三组HDL-C、LDL-C水平比较,健康对照组>甲功正常HT组>甲功异常HT组。三组IMT、VWD水平比较差异无统计学意义;三组SD、SI、PWV水平比较,健康对照组<甲功正常HT组<甲功异常HT组。三组杨氏模量值比较,健康对照组<甲功正常HT组<甲功异常HT组。经ROC曲线处理,结果显示杨氏模量值诊断HT患者的曲线下面积为0.818±0.039（P<0.001,95%CI：0.741~0.895）,最佳截断值为56.980 KPa,敏感度0.711,特异度0.829。结论 HT患者常伴随有血脂代谢紊乱,运用SWE结合R-VQS技术可对HT患者进行诊断,有助于早期发现颈动脉病变,对HT患者的治疗及预后具有一定的参考意义。
Abstract
Objective To explore the application value of shear wave elastography (SWE) combined with holographic vascular hardness analysis (R-VQS) in the diagnosis of Hashimoto's thyroiditis.
Methods A total of 70 female patients with new-onset HT or previous HT who had not received antithyroid medication who presented to our hospital from July 2022 to July 2023 were selected. The healthy control group consisted of 30 age-matched healthy females who underwent physical examination at our hospital during the same period of time. The 70 patients with HT were divided into 56 cases in the abnormal thyroid function HT group and 14 cases in the normal thyroid function HT group according to normal thyroid function or not. Total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), thyroglobulin antibody (TgAb), carotid intima-media thickness (IMT), carotid PWV, stiffness index (SI), right common carotid artery systolic diameter (SD), vascular wall displacement (VWD), and Young's modulus were compared among the three groups, and the diagnosis of HT was made by ROC. To analyze the value of Young's modulus values for diagnosis of HT patients.
Results Comparing the levels of TC, TG and TgAb in the three groups, the healthy control group<normal HT group<abnormal HT group; comparing the levels of HDL-C and LDL-C in the three groups, the healthy control group>normal HT group>abnormal HT group. Comparison of IMT and VWD levels among the three groups showed no statistically significant difference; comparison of SD, SI and PWV levels among the three groups showed that the healthy control group>the metabolic function normal HT group<the metabolic function abnormal HT group. Comparing the values of Young's modulus among the three groups, healthy control group<normal HT group<abnormal HT group. After ROC curve processing, the results show that the area under the curve of Young's modulus value in diagnosing HT patients is 0.818±0.039 (
P<0.001, 95%
CI: 0.741~0.895), the best cutoff value is 56.980 KPa, sensitivity is 0.711, and specificity is 0.829.
Conclusion HT patients are often accompanied by dyslipidemia. Using SWE combined with R-VQS technology can diagnose HT patients, and help to find carotid artery lesions early, which has certain reference significance for the treatment and prognosis of HT patients.
关键词
剪切波弹性成像 /
全息血管硬度分析 /
桥本氏甲状腺炎 /
诊断
Key words
shear wave elastography /
holographic vascular stiffness analysis /
Hashimoto's thyroiditis /
diagnose
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基金
广东省中医药科研项目“基于磁共振GABA波谱分析探讨‘安神补肾法’针刺治疗联合耳穴压豆对心肾不交型失眠的疗效及机制研究”（20242099）; 梅州市医药卫生科研立项“梅州市联合R-VQS及V-Flow技术多维度评估桥本氏甲状腺炎的临床研究”（2023-B-41）; 梅州市人民医院科研培育项目“SWE联合R-VQS及V-Flow技术多维度定量评估桥本氏甲状腺炎的临床研究”（PY-C2022014）
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