Role of ultrasound and Doppler findings as a predictor of thyroid hormonal levels in cases of Hashimoto thyroiditis

Abstract

Background Chronic lymphocytic thyroiditis or Hashimoto’s thyroiditis (HT) is a common form of organ specific autoimmune disease mediated by anti-thyroid autoantibodies. Ultrasound including Doppler is helpful diagnostic tool in the diagnosis of Hashimoto’s thyroiditis. This study aimed to evaluate the ultrasound and Doppler characters of Hashimoto thyroiditis and to analyze the relationship between these ultrasound, Doppler features and thyroid hormones level. Results Thyroid gland sonographic parenchymal abnormalities (septations, undulation, micronodularity, gland hyper vascularity, hypoechogenicity, sizable nodules as well as enlarged para-tracheal lymph nodes) were significantly higher in Hashimoto cases compared to control group (P value is < 0.001). Undulation of thyroid gland margin was the most sensitive sonographic sign seen in about 72% of studied cases. Thyroid stimulating hormone (TSH) level was significantly high in cases with grade 2 echogenicity compared to cases with grade 0 and grade 1 echogenicity and was significantly high in cases with para-tracheal abnormal enlarged lymph nodes (p < 0.05). TSH & thyroxine (T4) levels were significantly high in cases with high gland vascularity in Doppler study (p < 0.05). Conclusions Ultrasound is a very good diagnostic tool in HT with established signs. It can suggest hypothyroidism (high TSH) in cases of grade 2 parenchymal echogenicity, high vascularity and para-tracheal lymph nodes enlargement. These finding could be helpful in patient management and can contribute in better understanding the disease progression.

Assessment of Thyroid Stiffness and Viscosity in Autoimmune Thyroiditis Using Novel Ultrasound-Based Techniques

“…In addition to the volume enlargement, the typical inhomogeneous, hypoechoic, pseudonodular ultrasound appearance of the disease is caused by immune cell-mediated cytotoxicity leading to thyrocyte destruction and infiltration of the parenchyma with inflammatory cells and eventually to fibrosis [ 9 ]. The Doppler findings are also useful—most cases present increased vascularity, which may represent a diagnostic clue [ 10 ]. Thyroid elastography has great potential in the US detection of autoimmune thyroiditis, given its pathological features and the presence of fibrosis.…”