【摘要】 目的探讨彩色多普勒超声在新生儿先天性甲状腺功能减低症(CH)筛查中的临床应用价值。方法随机选取2016年1月至2018年10月在云南省第一人民医院出生的500例新生儿,观察甲状腺大小、形态及内部回声情况,对其各径线及剪切波弹性速度值进行测量,并采用彩色多普勒血流显像(CDFI)观察腺体内血流情况,将超声检测结果与血清FT3、FT4及促甲状腺激素(TSH)作对照分析。结果确诊CH的198例,占39.6%,其中以甲状腺肿大为主,占50.5%,声像图基本正常占24.2%,甲状腺结节或囊肿占10.6%,甲状腺发育不良占5.6%,甲状腺异位占5.0%,甲状腺先天缺如占4.0%。CH患儿彩色多普勒血流显像(CDFI)血流丰富,或呈"火海征",占47.8%;CH组甲状腺各径线及血流丰富程度明显高于正常新生儿(P<0.05),CH组甲状腺剪切波弹性值与正常新生儿比较,差异无明显统计学意义(P>0.05)。结论彩色多普勒超声对于甲状腺发育不良、异位或缺如能较早确诊,为临床选择治疗方案提供参考依据,超声具有简便、迅速、经济、无创伤、无辐射、实时动态、可重复性好等优点,是CH检查的首选方法。更多还原

【Abstract】 Objective To explore the clinical value of color Doppler ultrasonography in screening neonatal hypothyroidism(CH). Methods 500 neonates born in our hospital from 2016 to 2018 were randomly selected.The size, shape and internal echo of thyroid gland were observed. The elastic velocity of each diameter and shear wave were measured. The blood flow in gland was observed by color Doppler flow imaging. The results were compared with FT3, FT4 and TSH. Results 198 cases of CH were diagnosed, accounting for 39.6%. Among them, goiter accounted for 50.5%. Ultrasonography was basically normal in 24.2%. Thyroid nodules or cysts accounted for 10.6%. Thyroid dysplasia accounted for 5.6%. Ectopic thyroid accounted for 5.0%. Congenital absence of thyroid accounted for 4.0%. Color Doppler flow imaging(CDFI)showed rich blood flow or "sea of fire" sign, accounting for 47.8%. Thyroid diameter and blood flow richness in CH group were significantly higher than those in normal newborns; There was no significant difference in thyroid elasticity between CH and normal newborns(P>0.05). Conclusion Color Doppler ultrasonography can diagnose thyroid dysplasia, ectopic orabsent thyroid at an early date, and provide reference for clinical treatment. It has the advantages of simplicity,rapidity, economy, non-trauma,non-radiation, real-time dynamic and good repeatability. It is the preferred method for CH examination.更多还原