| Objective: evaluation of the diagnostic role of ultrasonography for hypothyroidism.Methods: The normal control group for the years of healthy volunteers,male 4 and female 16. the experimental group,diagnosed untreated patients with hypothyroidism in January 2009 to 2010 in the second hospital of Hebei Medical University, (excluding secondary hypothyroidism, or adrenal disease and chronic liver disease caused by hypothyroidism),Course of disease in patients less than 3 months, by reducing the level of thyroid function is divided into sub-clinical hypothyroidism and clinical hypothyroidism group,(Subclinical hypothyroidism group serology: TSH↑, FT4,FT3 in the normal frame of reference, the review of clinical hypothyroidism group serology search: TSH↑, FT3↓, FT4↓),20 patients in each group of patients, clinical hypothyroidism in patients with anti-thyroid peroxidase antibody<1300U/ml, both clinical hypothyroidism caused by Hashimoto's thyroiditis. the thyroid function test before ultrasound examination. Philips IU22 using color Doppler ultrasonic diagnostic apparatus, high-frequency probe, probe frequency of 7.5MHz, sample volume of about 1.0mm, sound beam and blood flow in the direction of beam angle< 60°. In a quiet state, the patient admitted supine position, head slightly thrown back, fully exposed neck. Conventional two-dimensional ultrasound observation and measurement of thyroid sonographic features of bilateral thyroid length (D1), width (D2), thickness (D3), continuous measurement of three times averaged.Color Doppler flow imaging observation of the thyroid gland blood flow distribution measured the superior thyroid artery diameter. Application of spectral doppler in the superior thyroid artery into the upper pole of thyroid gland before the 5 ~ 10mm measured at the systolic maximum velocity (Vmax) and resistance index (RI), continuous measurement of three times averaged. Each of the groups on both sides of superior thyroid artery diameter, Vmax, RI are added together, seeking unilateral leaves the average of each index. According to V = (Π/ 6)×D1×D2×D3, the calculation of unilateral thyroid volume V = (VL + VR) / 2.Application SPSS11.5 statistical software to conduct statistical analysis of the data obtained. Data with mean±standard deviation, said multiple comparison using analysis of variance and F test, pairwise comparison test with q test, the relevant comparison to do linear correlation analysis, count data using chi-square test,it was a statistical significance when P <0.05.Results:1 Ultrasound examination results1.1 Two-dimensional ultrasonographic features1.1.1 The internal echo characteristics of thyroid glandThyroid control group on both sides of leaf symmetry, shape rules, capsule integrity, and capsule smooth, glands into a medium-echo, even a small spot. Subclinical hypothyroidism thyroid gland increased to varying degrees, form full, glands of internal echo reduced spot thickening and less evenly distributed. Clinical hypothyroidism thyroid gland increased, non-uniform internal echo is obviously reduced, in some patients the thickness of the thyroid gland can be seen, ranging from irregular grid of high echo belt. Difference between the three groups were statistically significant (P <0.05).1.1.2 The length, width, thickness and volume of thyroidThe length, width, thickness and volume of thyroid in subclinical hypothyroidism group and clinical hypothyroidism group compared with control group differences were statistically significant (P < 0.05), and compared with control group increased. The thickness of thyroid in subclinical hypothyroidism group compared with clinical hypothyroidism group was no significant difference (P > 0.05), the other differences were statistically significant (P <0.05).1.2 Characteristics of color Doppler ultrasound 1.2.1 The diameter of the superior thyroid arteryThe superior thyroid artery diameter was significantly among three groups(P<0.05), The diameter of the superior thyroid artery in subclinical hypothyroidism and clinical hypothyroidism group is wider than in the control group, difference between the subclinical hypothyroidism and clinical hypothyroidism group were statistically significant (P <0.05),clinical hypothyroidism group widened even more obvious.1.2.2 Thyroid blood flow characteristics within the organizationIn control group, blood flow signals within the thyroid tissue is not abundant, showing sparse distribution of points and fascicular blood flow signals. In subclinical hypothyroidism and clinical hypothyroidism group,there are increased blood flow signals within the thyroid gland, some patients full of color flow signals within the thyroid gland. The differences were statistically significant (P < 0.05), subclinical hypothyroidism group compared with clinical hypothyroidism group was no significant difference (P> 0.05).1.3 Spectral Doppler ultrasonography1.3.1 The superior thyroid artery systolic maximum velocity (Vmax)Subclinical hypothyroidism and clinical hypothyroidism group compare with control group,there was significant difference (P <0.05),, the superior thyroid artery systolic maximum velocity was increase than those in the control group,subclinical hypothyroidism group compared with Clinical hypothyroidism group was no significant difference ( P> 0.05).1.3.2 Resistance Index (RI)The resistance index of the superior thyroid artery was no significant difference among three groups (P>0.05).1.4 Spectral Doppler curvesThe control group was low-speed low resistance Doppler spectrum shape type. The velocity in Subclinical hypothyroidism and clinical hypothyroidism group was higher than the control group,but also were low-impedance-type spectrum, spectrum peaks was blunt, diastolic flow decreased more slowly and evenly.2 Related Research2.1 The correlation of the highest systolic velocity (Vmax)of the superior thyroid artery and the unilateral thyroid volume(V)The the highest systolic velocity and unilateral thyroid volume were positively correlated in subclinical hypothyroidism and clinical hypothyroidism group through to do linear correlation analysis, the correlation coefficient were as follows: 0.62, 0.71.2.2 The correlation of the diameter of superior thyroid artery and the thyroid stimulating hormone levelsThe diameter of superior thyroid artery and the thyroid stimulating hormone levels were positively correlated in subclinical hypothyroidism and clinical hypothyroidism group through to do linear correlation analysis, the correlation coefficient were as follows: 0.59,0.67.Conclusion:1 In patients with hypothyroidism(Course of disease in patients less than 3 months)the thyroid internal echo thickening, localized or diffuse echo reduction.Subclinical hypothyroidism in patients with diffuse thyroid gland to reduce the echo within the majority of those without a high echo belt,the majority of clinical hypothyroidism in patients with diffuse echo reduction and the formation of high-echo belt. Therefore, echo characteristics of the thyroid gland can be used as reference for the diagnosis of hypothyroidism.2 In patients with hypothyroidism(Course of disease in patients less than 3 months)the thyroid volume and each diameter lines were increased,more significantly increased in patients with clinical hypothyroidism, these indicators reflect the status of thyroid function may be the disease development and treatment evaluation.3 In patients with hypothyroidism (Course of disease in patients less than 3 months)the thyroid tissue may also occur the phenomenon of increased blood flow signal, it seems as"sea of fire levies", broadening the superior thyroid artery diameter, flow rate increased, but the subclinical hypothyroidism and clinical hypothyroidism between the two groups had no significant difference, so thyroid blood flow characteristics within the organization still does not reflect the degree of hypothyroidism..4 In patients with hypothyroidism(Course of disease in patients less than 3 months)the highest systolic velocity of the superior thyroid artery and the unilateral thyroid volume were positively correlated.5 In patients with hypothyroidism(Course of disease in patients less than 3 months)the thyroid artery diameter and thyroid stimulating hormone level was positively correlated.
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