CAJ | 학술논문

目的：探讨超声与CT在桥本甲状腺炎中的应用价值。方法回顾性分析我院2012年9月-2014年9月经病理学确诊的69例(108个结节)桥本甲状腺炎患者的超声和CT资料，对比两种诊断方式的诊断准确率、敏感性、特异性，分析超声与CT征象。结果以病理学诊断作为“金标准”，超声诊断符合率为85.19%，CT诊断符合率为93.52%，差异显著，具有统计学意义(P＜0.05)；超声征象均表现为甲状腺不对称性肿大，其中69个结节形态规则，呈椭圆形或垂直型分布，51例甲状腺实质背影发生网络样、斑片、结节样改变；内部回声均改变，其中47例表现低回声，11例高回声，8例等回声，3例混合回声；35例出现点状、环状或团状钙化影，10例存在声晕；CDFI显示，64例可探及血流信号。CT征象显示59例呈单纯弥漫性改变，密度均匀减低，与周围软组织密度大致相同；6例甲状腺增大，存在多发小结节；4例甲状腺对称性增大，存在单发小结节，密度减低，且存在低密度影；CT平扫显示甲状腺边缘清晰，密度呈不均匀减低，增强扫描时结节区密度减低，与周围组织边界清晰，无钙化影。结论 CT诊断HT的准确性略高于超声，但两者特异性均较低，可联合检查提高诊断准确率。
목적：탐토초성여CT재교본갑상선염중적응용개치。방법회고성분석아원2012년9월-2014년9월경병이학학진적69례(108개결절)교본갑상선염환자적초성화CT자료，대비량충진단방식적진단준학솔、민감성、특이성，분석초성여CT정상。결과이병이학진단작위“금표준”，초성진단부합솔위85.19%，CT진단부합솔위93.52%，차이현저，구유통계학의의(P＜0.05)；초성정상균표현위갑상선불대칭성종대，기중69개결절형태규칙，정타원형혹수직형분포，51례갑상선실질배영발생망락양、반편、결절양개변；내부회성균개변，기중47례표현저회성，11례고회성，8례등회성，3례혼합회성；35례출현점상、배상혹단상개화영，10례존재성훈；CDFI현시，64례가탐급혈류신호。CT정상현시59례정단순미만성개변，밀도균균감저，여주위연조직밀도대치상동；6례갑상선증대，존재다발소결절；4례갑상선대칭성증대，존재단발소결절，밀도감저，차존재저밀도영；CT평소현시갑상선변연청석，밀도정불균균감저，증강소묘시결절구밀도감저，여주위조직변계청석，무개화영。결론 CT진단HT적준학성략고우초성，단량자특이성균교저，가연합검사제고진단준학솔。
Objective To explore the application value of ultrasound and CT in Hashimoto thyroiditis.Methods The ultrasound and CT data of 69 patients (108 nodules) with Hashimoto thyroiditis confirmed by pathology during September 2012 to September 2014 were retrospectively analyzed. The diagnostic accuracy, sensitivity and specificity were compared between the two kinds of diagnostic mehods. The ultrasound and CT signs were analyzed.Results With the pathological diagnosis as the golden standard, the diagnostic accordance rate of ultrasound was 85.19% and of CT was 93.52%. The difference was statistically significant (P<0.05). The ultrasonic signs manifested as asymmetric goiters. The shape of 51 nodules was regular, oval or vertical distribution; Net-shaped, patch-like and nodular changes occurred in 51 cases of thyroid essence shadow. Internal echo changed, including 47 cases manifesting as low echo, 11 cases as high echo, 8 cases as isoecho and 3 cases as mixed echo; There was punctiform, annular or nest-like calcified shadow in 35 cases and acoustic halo in 10 cases. CDFI showed that 64 cases can be detected with blood flow signal. CT findings showed that 59 cases showed simple diffuse changes and density uniformly decreasing which was similar to the density of surrounding soft tissues; 6 cases were with enlargement of the thyroid gland and multiple small nodules; 4 cases were with asymmetric goiters and solitary small nodules. The density reduced, with low density shadow; CT scan showed clear edge of the thyroid and density uniformly decreasing. When enhancement scan was performed, the density of nodule area reduced, with clear boundary with the surrounding tissues, without calcified shadow.Conclusion The accuracy of CT in diagnosis of HT was slightly higher than that of ultrasound, but the specificity of both of them was relatively low. Combined inspection can be used to improve the diagnostic accuracy.