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。

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.