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目的探讨超声弹性对比指数(ECI)在桥本氏甲状腺炎(HT)的诊断价值。方法按灰阶超声检查结果将HT患者分为微小结节组和网格组,分别与正常组ECI、血清甲状腺微粒体抗体(TPOAb)及甲状腺球蛋白抗体(TGAb)值进行对比分析。结果正常组20例,87例临床明确诊断HT患者中,微小结节组54例,网格组33例。正常组ECI值为1.04±0.40,微小结节组ECI值为2.20±0.85,血清TPOAb为277.47(13.85,551.18)IU/ml,TGAb为308.63(3.13,86.70)IU/ml。网格组ECI值为3.36±1.45,血清TPOAb为310.05(30.18,554.13)IU/ml,TGAb为104.26(2.78,116.25)IU/ml。分别将正常组、微小结节组和网格组ECI值进行两两比较,上述三组之间均具有明显统计学差异(P均<0.001)。分别将微小结节组和网格组血清TPOAb和TGAb分别进行比较,上述两组之间均未见明显统计学差异(P均>0.05)。结论血清TPOAb和TGAb不能反映桥本氏甲状腺炎不同超声类型的差异,而ECI可评价甲状腺实质的均一性,可作为判断桥本氏甲状腺炎不同超声类型的半定量指标,从而客观评价甲状腺弥漫性病变。
Objective To investigate the diagnostic value of ultrasound contrast index (ECI) in Hashimoto’s thyroiditis (HT). Methods According to the results of gray scale ultrasonography, HT patients were divided into two groups: nodule group and grid group. The levels of ECI, TPOAb and TGAb in the normal group were compared respectively. Results In 20 cases of normal group, 87 cases of clinically diagnosed HT patients, 54 cases of minimal nodules and 33 cases of grid group. The ECI of the normal group was 1.04 ± 0.40, the ECI of the tiny nodule group was 2.20 ± 0.85, the serum TPOAb was 277.47 (13.85,551.18) IU / ml and the TGAb was 308.63 (3.13, 86.70) IU / ml. The ECI value of the grid group was 3.36 ± 1.45, the serum TPOAb was 310.05 (30.18, 554.13) IU / ml and the TGAb was 104.26 (2.78, 116.25) IU / ml. The ECI values of normal group, small nodule group and grid group were compared with each other. There was significant statistical difference between the three groups (all P <0.001). The serum TPOAb and TGAb in the tiny nodule group and the grid group were compared respectively. There was no significant difference between the two groups (P> 0.05). Conclusions The serum levels of TPOAb and TGAb can not reflect the differences of ultrasound types in Hashimoto’s thyroiditis. ECI can evaluate the homogeneity of thyroid parenchyma, which can be used as a semi-quantitative index for judging Hashimoto’s thyroiditis with different ultrasound types, so as to objectively evaluate thyroid diffuseness Lesions.