Bennedbaek F N, Hegedüs L
Department of Endocrinology M, Odense University Hospital, Denmark.
Thyroid. 1997 Feb;7(1):45-50. doi: 10.1089/thy.1997.7.45.
Twenty-three consecutive patients with clinical and biochemical suspicion of subacute thyroiditis (SAT) were evaluated by ultrasonic scanning of the thyroid. Ultrasonic findings supported the diagnosis in all cases. In the 16 patients in whom thyroid scintigraphy was performed this was compatible with SAT. Initially, median thyroid volume was 40 mL (range 20-289) and a very low echogenicity was demonstrated in all patients. The extension of hypoechogenicity exceeded 75% in the majority of patients. Thyroid volume was significantly reduced to a median of 13 mL (range 9-40) (68% reduction, p < 0.00001) at a median follow-up period of 18 months (range 6-33) and a majority of the patients (60%) had persistent morphological abnormalities. No correlation between thyroid function and the extension of hypoechogenicity initially or at end of follow-up could be demonstrated. Recurrence was noted in 8 patients (35%), two of whom were positive for anti-TPO antibodies, but the risk of recurrence could not be correlated to the extension of hypoechogenicity or initial thyroid function. Recurrence was related to the further extention of hypoechoic areas and increase in thyroid volume, as evidenced by ultrasonography in our series. None developed thyroid antibodies, and all were euthyroid at the end of the observation period. We believe that high resolution ultrasonography has a useful supporting role in the diagnosis of subacute thyroiditis. In case of doubt and differential diagnostic considerations, it facilitates guided biopsies. Additionally, it allows determination of disease activity and thyroid size.
对23例临床及生化检查怀疑为亚急性甲状腺炎（SAT）的连续患者进行了甲状腺超声扫描评估。所有病例的超声检查结果均支持诊断。在16例行甲状腺闪烁显像的患者中，结果与SAT相符。最初，甲状腺体积中位数为40 mL（范围20 - 289），所有患者均表现为极低回声。大多数患者低回声范围超过75%。在中位随访期18个月（范围6 - 33个月）时，甲状腺体积显著减小至中位数13 mL（范围9 - 40）（减小68%，p < 0.00001），大多数患者（60%）存在持续性形态异常。在随访初期或末期，均未发现甲状腺功能与低回声范围之间存在相关性。8例患者（35%）出现复发，其中2例抗甲状腺过氧化物酶（TPO）抗体阳性，但复发风险与低回声范围或初始甲状腺功能无关。在我们的系列研究中，超声检查显示复发与低回声区域进一步扩大及甲状腺体积增加有关。所有患者均未产生甲状腺抗体，在观察期结束时甲状腺功能均正常。我们认为高分辨率超声检查在亚急性甲状腺炎的诊断中具有重要的辅助作用。在存在疑问及鉴别诊断时，它有助于引导活检。此外，它还能确定疾病活动度及甲状腺大小。
