Objective To evaluate the features of ultrasound and elastography of chronic lymphocytic thyroiditis (CLT) with different thyroid functions,analyze the course of the disease and provide a basis for clinical treatment.Methods A total of 77 patients with CLT were retrospectively analyzed in the Department of Ultrasound,Fourth Affiliated Hospital of Harbin Medical University from September 2013 to September 2014.The patients were divided into four groups based on thyroid function,including 20 patients with hyperthyroidism,18 patients with hypothyroidism,20 patients with subclinical hypothyroidism,and 19 patients with euthyroidism.According to 6 indicators consisted of the thyroid size (volume,thickness of the lateral lobe,thickness of the isthmic portion),flow classification(0,Ⅰ,Ⅱ,Ⅲ),the peak systolic velocity (PSV) of the superior thyroid artery(STA),resistance index (RI) of the STA,echo types (diffuse,localized) and ultrasound elastic rate (E2/E1),the features of ultrasound and elastography of CLT were analyzed.According to the thyroid echo types and different thyroid functions,the change of E2/E1 was analyzed and the relationship between E2/E1 in different thyroid function and thyroid function (thyroid stimulating hormone,TSH) was compared.Results The volume,thickness of the lateral lobe of hypothyroidism,subclinical hypothyroidism,hyperthyroidism and euthyroidism groups were respectively as follows:(14.25 ± 4.15),(11.79 ± 3.22),(9.84 ± 2.63),(5.61 ± 1.35) ml and (2.35 ± 0.27),(2.15 ± 0.24),(1.97 ± 0.16),(1.62 ± 0.22) cm,and the differences between different groups were statistically significant (F =27.77,35.56,all P ＜ 0.05).The thickness of the isthmic portion was respectively as follows:(0.53 ± 0.09),(0.47 ± 0.06),(0.44 ± 0.06),(0.38 ± 0.06) cm,and the differences between different groups were not statistically significant (F =14.76,P ＞ 0.05).The PSVs were respectively as follows:(50.53 ± 10.61),(42.93 ± 7.81),(64.96 ± 12.20),(34.74 ± 6.05) cm/s,and the differences between different groups were statistically significant (F =36.06,P ＜ 0.05).The RIs were respectively as follows:0.59 ± 0.04,0.60 ± 0.02,0.63 ± 0.02,0.60 ± 0.02,and the differences between different groups were not statistically significant (F =7.66,P ＞ 0.05).Patients with euthyroidism had Color Doppler Flow Imaging (CDFI) pattern 0 (52.6％,10/19).Patients with subclinical hypothyroidism had CDFI pattern Ⅰ (60.0％,12/ 20).Patients with hypothyroidism had CDFI pattern Ⅱ (66.7％,12/18).Patients with hyperthyroidism had CDFI pattern Ⅲ (55.0％,11/20).The thyroid gland echo in CLT groups was mainly diffuse hypoechoic pattern (62.3％,48/ 77).Focal hypoechoic pattern and diffuse hypoechoic pattern without heterogeneous linear hypoechoic were mainly seen in the groups of hyperthyroidism and euthyroidism (66.7％,26/39).Diffuse hypoechoic pattern with heterogeneous linear hypoechoic and nodular changes were mainly seen in the groups of hypothyroidism and subclinical hypothyroidism (86.9％,33/38).The E2/E1 in focal hypoechoic pattern,diffuse hypoechoic pattern without heterogeneous linear hypoechoic pattern,diffuse hypoechoic pattern with heterogeneous linear hypoechoic and nodular changes were by turns:1.30 ± 0.48,1.68 ± 0.38,1.97 ± 0.55,2.27 ± 0.63,and the differences between different groups were statistically significant (F =32.47,P ＜ 0.05).The E2/E1 in hyperthyroidism,euthyroidism,subclinical hypothyroidism,and hypothyroidism were by turns:1.12 ± 0.50,1.69 ± 0.12,2.21 ± 0.20,2.45 ± 0.32,and the differences between different groups were statistically significant (F =64.54,P ＜ 0.05).The correlation coefficient between E2/E1 and serum TSH was 0.742,which was significant (P ＜ 0.01) in different thyroid function groups.Conclusions CLT with different thyroid functions has different features of ultrasound and elastography.E2/E1 can reflect the hardness of the thyroid parenchyma to a certain extent,and assess the thyroid function and the course of the disease,can prevent the occurrence of hypothyroidism early.

Objective To explore the application value of ultrasound elasticity index ratio and elasticity index methods in differential diagnosis of different sizes of benign and malignant thyroid nodules.Methods Clinical examination data of patients who were hospitalized for thyroid nodules were collected and were retrospectively analyzed in the Fourth Affiliated Hospital of Harbin Medical University from January 2015 to January 2016.The elasticity index ratio and elasticity index were used to diagnose benign and malignant thyroid nodules,and the results were compared with pathological diagnosis.The thyroid nodules were fell into three groups according to the maximum long diameter:＜ 1,1-2,and ＞ 2 cm.Using the above two methods,the sensitivity,specificity and accuracy were analyzed in benign and malignant thyroid nodules with different sizes.And the receiver operating characteristic curve (ROC) was drawn.Results A total of 90 patients (108 nodules) were enrolled in the study and they were from thyroid nodular surgery,28 male cases,62 female cases,mean age (44.1 ± 11.5) years,and ranged from 20 to 69 years old.Seventy benign nodules and 38 malignant nodules were diagnosed with pathology.Sixtythree benign nodules and 45 malignant nodules were diagnosed via the ultrasound elasticity index ratio method.Compared with the pathological diagnosis,13 were misdiagnosed and 6 were omission diagnosed in malignant thyroid nodules.Sixty-three benign nodules and 45 malignant nodules were diagnosed via the ultrasound elasticity index method.Compared with the pathological diagnosis,16 were misdiagnosed and 9 were omission diagnosed in malignant thyroid nodules.Sensitivities of elasticity index ratio method in ＜ 1,1-2,and ＞ 2 cm groups were 91.7％,86.0％,and 75.0％;specificities were 88.9％,78.6％,and 79.2％,and accuracies were 90.0％,81.0％,and 77.8％;and differences in sensitivity and accuracy of the two methods were statistically significant (x2 =76.4,70.8,P ＜ 0.05).Sensitivities of elasticity index method in ＜ 1,1-2,and ＞ 2 cm were 83.3％,78.6％,and 66.7％;specificities were 83.3％,75.0％,and 75.0％,and accuracies were 83.3％,76.0％,and 72.2％.Differences in sensitivity and accuracy of the two methods were statistically significant (x2 =82.8,74.5,P ＜ 0.05).The area under the ROC curve of elasticity index ratio and of elasticity index was 0.814 and 0.766,respectively,and the difference was statistically significant (Z =0.896.P ＜ 0.05).Conclusions In the differential diagnosis of different sizes of benign and malignant thyroid nodules,the elasticity index ratio method is better than the elasticity index method.The diagnostic value on ≤ 2 cm nodules is higher.

Objective To explore the value ofspatio-temporal image correlation (STIC) technique in diagnosis of fetal ductus arteriosus aneurysm (DAA).Methods A total of 67 pregnant women,diagnosed with fetal ductus arteriosus aneurysm,were selected from the Fourth Affiliated Hospital of Harbin Medical University,between September 2014 and September 2016.2DE and STIC techniques were used to observe the form of fetal ductus arteriosus aneurysm.STIC technique was used to measure the maximum diameter,minimum diameter,systolic peak velocity,and diastolic velocity of ductus arteriosus aneurysm in 40 cases caused by ductus arteriosus stenosis.Pearson linear correlation analysis was applied to analyze the correlation between the maximum diameter and the minimum diameter,systolic peak velocity and diastolic velocity.The maximum diameters of 67 ductus arteriosus aneurysm were measured by 2DE and STIC techniques,and the above measurements were repeated one week later.ICC was used to analyze the consistency between 2DE and STIC technique,and internal consistency of 2DE and STIC technique,respectively.Results Pearson linear correlation analysis showed that the maximum diameter of the DAA was negatively correlated with the minimum diameter (r=-0.755,P ＜ 0.001) significantly,and positively correlated with the systolic peak velocity (r=0.779,P ＜ 0.001) significantly.The internal consistency of STIC technique was the best of the three,followed by the consistency between 2DE and STIC techniques,with the 2DE,illustrating the lowest consistency.Conclusions STIC technique provides with more comprehensive and accurate volume data than 2DE in the diagnosis of fetal ductus arteriosus aneurysm.Thus,this technique is conducive to the early detection of ductus arterious stenosis,observation of hemodynamic changes,closely monitoring of relevant indicators to guide clinical timely intervention,and to improve the quality of life of children.