徐素音 游淑红 彭贵平

[摘要] 目的 探讨桥本氏甲状腺炎（Hashimoto thyroiditis，HT）行超声检查的临床诊断价值。 方法 选择2018年1月～2019年4 月62例于我院进行诊治的HT患者为研究对象（HT组），同期寻找32例健康志愿者作为对照组。对研究对象行常规超声检查以及彩色多普勒超声检查，观察其诊断准确性与图像特点。 结果 HT组患者的甲状腺部厚度以及左右叶的厚度、宽度均明显大于健康对照组;其PSV、RI水平也均大于对照组，差异有统计学意义（P<0.05）。患者的血流信号主要为Ⅰ级和Ⅱ级，分别占总数的40.32%、33.87%。超声检查在结节型、局限型、弥漫型HT的诊断正确率分别为95.24%、90.91%、93.33%，整体诊断正确率为93.55%。 结论 超声检查在HT的临床诊断中有良好价值，其诊断准确率较高，患者的超声图像有明显特征，血流变化明显，可为该疾病的诊断与鉴别提供有力參考。

[关键词] HT;临床诊断;常规超声;彩色多普勒超声

[中图分类号] R445.1          [文献标识码] B          [文章编号] 1673-9701（2020）17-0138-03

Clinical diagnosis value of ultrasound in Hashimoto thyroiditis

XU Suyin   YOU Shuhong   PENG Guiping

Ultrasonology Department，Jiujiang No.1 People's Hospital in Jiangxi Province，Jiujiang   332000，China

[Abstract] Objective To analyze the clinical diagnostic value of ultrasound examination in Hashimoto thyroiditis （HT）. Methods 62 HT patients diagnosed and treated in Jiujiang First People's Hospital from January 2018 to April 2019 were selected as the study subjects （HT group）， and 32 healthy volunteers were selected as the control group. All subjects underwent routine ultrasonography and color Doppler ultrasound to observe the diagnostic accuracy and imaging characteristics. Results The thickness of the thyroid gland and the thickness and width of the left and right lobes in the HT group were significantly greater than those in the control group; their peak systolic velocity （PSV） and resistance index （RI） levels were also greater than those in the control group， and the differences were statistically significant（P<0.05）. The patients' blood flow signals were mainly grades Ⅰ and Ⅱ， accounting for 40.32% and 33.87% of the total， respectively. The diagnostic accuracy of ultrasound in nodular， focal， and diffuse HT was 95.24%， 90.91%， and 93.33%， respectively. The overall diagnostic accuracy was 93.55%. Conclusion Ultrasonography is of great value in the clinical diagnosis of HT， and its diagnostic accuracy is rather high. Patients' ultrasound images have distinct features and changes in blood flow， which can provide a powerful reference for the diagnosis and differentiation of the disease.

[Key words] Hashimoto thyroiditis; Clinical diagnosis; Conventional ultrasound; Color Doppler ultrasound

桥本氏甲状腺炎（Hashimoto thyroiditis，HT）是发病率最高的甲状腺炎类型，属于自身免疫性疾病，其症状隐匿，早期几乎无症状，病情缓慢发展后可出现甲状腺不适、肿大、甲状腺功能异常等表现，给患者身体健康造成危害[1]。HT高发于中年群体，女性患者显著多于男性，其比例达到20：1左右[2]。该疾病的症状较普通，易与其他甲状腺疾病混淆，因此准确诊断、鉴别HT，并及早予以专业、有效的治疗十分重要。超声检查是临床诊断常用的辅助检查方式，具有无创伤、可反复、操作简单等优势，随着超声检查技术的不断成熟与发展，其对于疾病的诊断价值也不断提升。有相关研究表示，应用超声检查可直观地观察到甲状腺及周围淋巴结情况，可评估甲状腺功能，有助于诊断和鉴别甲状腺疾病[3]。本文对HT患者与健康志愿者进行对比分析，观察超声检查在HT临床诊断中的应用价值及其图像特征，现报道如下。……