彩色多普勒超声和实时弹性成像在甲状腺功能减退症患者中用于预测左甲状腺素替代治疗的效果:一项对 338 名患者进行的横断面研究。

IF 1.3 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Journal of Ultrasound Pub Date : 2024-06-01 Epub Date: 2024-02-23 DOI:10.1007/s40477-024-00876-x
Nikolaos Angelopoulos, Dimitrios G Goulis, Ioannis Chrisogonidis, Sarantis Livadas, Ioannis Iakovou
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引用次数: 0

摘要

目的:虽然激素测定常用于甲状腺功能评估,但多普勒超声检查可提供有关血管化和血流的宝贵信息。本研究旨在探讨多普勒参数与甲减患者临床特征(如疾病的自身免疫性和LT4替代的充分性)之间的潜在关联:本研究共纳入338名主要由自身免疫性甲状腺炎(AT)引起的甲减患者。排除标准包括特殊病症、用药史和甲状腺结节异常。研究记录了患者的人口统计学特征(年龄、性别、体重指数)、治疗参数(LT4每日剂量)和甲状腺激素水平(促甲状腺激素、fT4):在登记的患者中,85.2%患有自身免疫性甲状腺炎。20.1%的患者在入组时发现左甲状腺素(LT4)补充不足。与无自身免疫性疾病的患者相比,自身免疫性甲状腺炎患者的弹性成像比值增大,弹性成像比值与血管性呈正相关。在无自身免疫性甲状腺炎的患者中,LT4补充不足的患者甲状腺总容积较低。LT4补充不足的患者甲状腺下动脉的收缩峰值速度(PSV)和舒张末期速度(EDV)较高,阻力指数(RI)较低。以LT4剂量/体重指数(BMI)表示的甲状腺功能减退症严重程度与甲状腺容积和甲状腺上下动脉的EDV值呈负相关。甲状腺下动脉的PSV值可以预测LT4替代效果不理想的情况(灵敏度为81.8%,特异度为42%):结论:在抽血化验具有挑战性的情况下,利用彩色多普勒超声可作为一种替代方法来评估治疗反应,并确定需要进一步激素检查的患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Color Doppler ultrasound and real-time elastography in patients with hypothyroidism for the prediction of levothyroxine replacement: a cross-sectional study of 338 patients.

Aims: While hormonal assays are commonly used for thyroid function assessment, Doppler sonography provides valuable information on vascularization and blood flow. This study aimed to examine the potential associations between Doppler parameters and clinical characteristics of hypothyroid patients, such as the autoimmune nature of the disease and adequacy of LT4 replacement.

Methods: A total of 338 patients with hypothyroidism, primarily caused by autoimmune thyroiditis (AT), were enrolled in this study. Exclusion criteria comprised specific medical conditions, medication history, and nodular abnormalities of the thyroid gland. Patient demographics (age, sex, BMI), treatment parameters (LT4 daily dose), and thyroid hormone levels (TSH, fT4) were recorded.

Results: Among the enrolled patients, 85.2% had autoimmune thyroiditis. Suboptimal levothyroxine (LT4) replacement was observed in 20.1% of patients at the time of enrollment. Patients with autoimmune thyroiditis had increased elastography ratios compared to those without autoimmune disease and present a positive association of elastography ratios with vascularity. In patients without autoimmune thyroiditis, those with suboptimal LT4 replacement had lower total thyroid volume. Patients with suboptimal LT4 replacement had higher peak systolic velocity (PSV) and end-diastolic velocity (EDV) in the inferior thyroid artery and lower resistive index (RI). The severity of hypothyroidism, as indicated by LT4 dose/body mass index (BMI), was negatively correlated with thyroid volume and EDV values of superior and inferior thyroid arteries. PSV of the inferior thyroid artery can predict suboptimal LT4 replacement (sensitivity 81.8%, specificity 42%).

Conclusions: In situations where obtaining blood tests may be challenging, utilizing color Doppler ultrasound can serve as an alternative method to assess treatment responses and identify patients who require further hormonal examinations.

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来源期刊
Journal of Ultrasound
Journal of Ultrasound RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
4.10
自引率
15.00%
发文量
133
期刊介绍: The Journal of Ultrasound is the official journal of the Italian Society for Ultrasound in Medicine and Biology (SIUMB). The journal publishes original contributions (research and review articles, case reports, technical reports and letters to the editor) on significant advances in clinical diagnostic, interventional and therapeutic applications, clinical techniques, the physics, engineering and technology of ultrasound in medicine and biology, and in cross-sectional diagnostic imaging. The official language of Journal of Ultrasound is English.
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