Study On The Correlation Between Quantitative Imaging Technology Of Acoustic Palpation Tissue And TCM Syndromes In Hashimoto's Thyroiditis

Objective:To investigate the characteristics of the shear wave velocity(SWV)with virtual touch tissue quantification(VTQ)and virtual touch tissue imaging quantification(VTIQ),and also the correlation between thyroid SWV and thyroid functions and traditional Chinese medicine(TCM)syndrome in Hashimoto’s Thyroiditis(HT),so as to provide a more objective and reliable evidence for the diagnosis of Hashimoto’s thyroiditis in TCM.Methods:107 patients diagnosed as Hashimoto’s Thyroiditis in our hospital were collected as the experimental group from February 2017 to February 2019,including 11 male patients and 96 female patients,aged between 25 to 64 years old,with an average age of(41.9±8.2)years.44 healthy volunteers without thyroid symptoms and obvious ultrasound abnormalities were selected as the normal control group during the same period,including 5 males and 39 females,aged between 27 to 59 years old,with an average age of(43.0±9.0)years old.107 patients in the experimental group were divided into three subgroups according to different TCM syndromes which includes liver-qi stagnation and phlegm stagnation type(n=43),spleen-kidney Yang deficiency type(n=34)and qi-yin deficiency type(n=30).The patients were also divided into hypothyroidism group(including subclinical hypothyroidism and clinical hypothyroidism)(n=55),normal thyroid function group(n=31)and hyperthyroidism group(n=21)by the results of thyroid function measured by chemiluminescence.ACUSON S3000 ultrasound system offered by Siemens was used to evaluate SWV.First to scan the size and shape of the thyroid gland comprehensively and record the internal echo pattern with two-dimensional ultrasound,and then measured the SWV of the left lobe and right lobe in VTQ and VTIQ mode and calculated the average value of SWV.The SWV characteristics in HT patients of different TCM syndrome types and different thyroid function were analyzed respectively.The pairwise comparison of SWV between the experimental group and the control group was carried out by using the t-test.Drawing the receiver operating characteristics(ROC)according to the sensitivity and specificity to find out the optimal diagnostic value of HT.The comparison of SWV among groups with different TCM syndromes and groups with different thyroid functions were conducted by using oneway-anova,and then two independent sample t-test.The correlation between thyroid SWV and the TCM syndrome types in HT patients were analyzed by Spearman.The result is with statistical significance when P<0.05.Results:1.SWV of the experimental group measured by VTQ mode:left lobe(2.94±0.48)m/s,right lobe(2.89±0.47)m/s,mean value(2.92±0.44)m/s.SWV of the experimental group measured by VTIQ mode:left lobe(2.99±0.50)m/s,right lobe(2.92±0.44)m/s,mean value(2.95±0.44)m/s,the SWV different between VTQ and VTIQ was not statistically significant(P>0.05).SWV of the control group measured by VTQ:left lobe(2.03±0.25)m/s,right lobe(1.98±0.30)m/s,mean value(2.00±0.26)m/s,SWV of the control group measured by VTIQ mode:left lobe(2.03±0.24)m/s,right lobe(2.02±0.28)m/s,mean value(2.03±0.25)m/s,The SWV values of left and right lobe in experimental group were all greater than those in the control group,so does the mean value(P=0.00).2.In VTQ,the mean values of SWV in the three groups(liver-qi stagnation and phlegm stagnation type,spleen-kidney yang deficiency type,qi-yin deficiency type)were(3.09±0.38)m/s,(2.77±0.43)m/s,and(2.84±0.47)m/s respectively.In VTIQ,the mean values of SWV were(3.10±0.38)m/s,(2.82±0.43)m/s,(2.90±0.48)m/s respectively.There was a statistically significant difference in the mean values of SWV between the liver-qi stagnation and phlegm stagnation type and spleen-kidney yang deficiency type(P=0.00).There was no statistically significant difference in the mean values of SWV between the liver-qi stagnation and phlegm stagnation type and the qi-yin deficiency type(P>0.05),neither in spleen-kidney yang deficiency type and qi-yin deficiency type.There was a correlation between thyroid mean SWV and TCM syndromes in HT patients(r=-0.23,P=0.02).3.In VTQ,the mean values of SWV in three subgroups(hypothyroidism group,normal thyroid function group,hyperthyroidism group)were(2.94±0.50)m/s,(2.97±0.37)m/s and(2.79±0.39)m/s respectively.There was no significant difference among these three groups(P>0.05).In VTIQ,the mean values of SWV were(2.99±0.48)m/s,(2.98±0.39)m/s,and(2.82±0.38)m/s,with no statistically significant difference(P>0.05).Conclusion:1.The SWV mean value of thyroid in healthy people was(2,03±0.25)m/s,and that in HT patients was(2.95±0.44)m/s.VTQ and VTIQ could be used to differentiate HT and healthy people.The best cut-off point was 2.43m/s.VTQ and VTIQ have the similar diagnostic ability of for HT.2.The SWV of left lobe in healthy thyroid gland was(2.03±0.24)m/s,and the right lobe SWV was(2.02±0.28)m/s.There was no difference in the hardness of the left and right lobes.In HT patients,SWV in the left lobe of the thyroid was(2.99±0.50)m/s,and SWV in the right lobe was(2.92±0.44)m/s,with no difference in the hardness between the left and right lobes.3.There is a certain correlation between SWV of thyroid in HT patients and TCM syndrome types.TCM syndrome type of liver-qi stagnation and phlegm stagnation has a higher SWV,showing that the TCM syndrome type has a certain correlation with thyroid hardness,which provided objective and reliable evidence for TCM syndrome type diagnosis and treatment of HT.This study could help to promote the development of integrated Chinese and Western medicine.There was no significant correlation between thyroid SWV and thyroid function,indicating that thyroid hardness had no significant correlation with thyroid function.The influencing factors of thyroid fibrosis are complex,and the process of thyroid fibrosis may be affected by various factors such as the progress of the disease course,different subtypes,clinical treatment and intervention,etc.,which provides a new scientific research idea for the discussion of the classification of HT,the influencing factors of the disease condition and the progress of the disease course.