Subacute Thyroiditis—An Often Overlooked Sonographic Diagnosis

Lee, Margaret Yee Wah; Lam, Winnie Wing Chuen; Wong, Wai Yin

doi:10.7863/ultra.15.05052

Cited by 3 publications

(2 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the recently published American College of Radiology (ACR) TIRADS ( 8 ), the presence of various sonographic features, including solid nodules, hypo-echogenicity, irregular margin, taller‑thanwide shape, and microcalcifications, were considered for evaluation of suspicious malignant thyroid nodules. However, in clinical practice, these features have also been detected in some benign nodules, especially inflammatory thyroid nodules (i.e., subacute granulomatous thyroiditis-related nodules) with a diffuse change in the thyroid gland (i.e., Hashimoto’s thyroiditis) ( 9 , 10 ). It has been noted that when thyroiditis occurs, the echogenicity of the thyroid gland becomes uneven on US images and some inflammatory nodules appear hypo-echogenic, with poorly defined margins and even dystrophic microcalcifications ( 11 , 12 ).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of contrast-enhanced ultrasound characteristics of inflammatory thyroid nodules and papillary thyroid carcinomas using a quantitative time-intensity curve: a propensity score matching analysis

Zhang¹,

Liu²,

Yang³

et al. 2022

Quant Imaging Med Surg

View full text Add to dashboard Cite

Background: This study aims to compare the contrast-enhanced ultrasound (CEUS) characteristics of inflammatory thyroid nodules with those of papillary thyroid carcinomas using time-intensity curve (TIC) analysis.Methods: This was a retrospective cohort study. Among the thyroid nodules in 2161 patients who underwent CEUS from July 2014 to April 2018, 44 nodules in 44 patients ultimately diagnosed as inflammatory nodules and 44 nodules in 44 patients confirmed as papillary carcinomas (enrolled from July 2016 to April 2018) were included after propensity score matching analysis (1:1). The average diameters of lesions in the inflammatory and malignant groups (n=44 each) were 0.92±0.34 cm and 0.89±0.42 cm, respectively. CEUS patterns were evaluated and classified into four types, namely concentric hypo-enhancement, heterogeneous hypoenhancement, hypo-enhancement with a sharp margin, and homogeneous hyper/iso-enhancement. The measured TIC parameters included peak intensity (PI), rise time (RT), time to peak (TTP), maximum slope rate of the ascending curve (AS), and maximum slope rate of the descending curve (DS). The CEUS patterns and TIC parameters were compared between the inflammatory nodules and papillary carcinomas. Results:The heterogeneous hypo-enhancement CEUS pattern was predominantly present in the inflammatory nodules. The concentric hypo-enhancement pattern was identified as a valuable predictive pattern for papillary carcinomas. For the TIC, inflammatory nodules had a lower PI [55.42 (45.41, 76.91) vs. 84.43 (74.93, 90.92)] [median (interquartile range)] and a smaller AS [22.39 (13.37, 29.93) vs. 29.54 (19.37, 44.77)], compared with papillary carcinomas (P<0.05).Conclusions: CEUS patterns with TIC parameters could provide effective and quantitative information for characterizing microvascular perfusion of inflammatory thyroid nodules and papillary carcinomas.

show abstract

Section: Introductionmentioning

confidence: 99%

“…The areas of necrosis and inflammatory cells within nodules may interfere with the FNA results, which usually leads to the need for more than one biopsy. Further, misdiagnosis of inflammatory nodules may result in unnecessary thyroid lobectomy ( 10 , 12 ).…”

Section: Introductionmentioning

confidence: 99%

Comparison of contrast-enhanced ultrasound characteristics of inflammatory thyroid nodules and papillary thyroid carcinomas using a quantitative time-intensity curve: a propensity score matching analysis

Zhang¹,

Liu²,

Yang³

et al. 2022

Quant Imaging Med Surg

View full text Add to dashboard Cite

show abstract

Painful Hashimoto Thyroiditis in a 7-Year-Old Girl: Differential Diagnosis and Medical Treatment

et al. 2021

View full text Add to dashboard Cite

Painful Hashimoto thyroiditis (HT) is a rare pediatric condition. Because of the rarity of painful HT, it can be misdiagnosed as other thyroid diseases, and there is limited evidence regarding its clinical course and treatment. A 7-year-old girl presented to the emergency room with neck pain. A physical examination revealed diffusely enlarged thyroid gland with firm consistency and without tenderness. Her serum free thyroxine level was decreased and levels of thyroid-stimulating hormone, thyroglobulin antibody, and thyroid-stimulating antibody were elevated. The ultrasonography revealed a diffusely enlarged thyroid gland with homogeneously hypoechoic parenchyma and lobulated contours. She was diagnosed with painful HT based on the clinical presentations, laboratory tests, and ultrasonography findings, and was treated with a steroid, levothyroxine, and nonsteroidal anti-inflammatory drugs, after which her clinical symptoms improved dramatically. We should consider the possibility of painful HT in children with neck pain; HT could be treated with medical treatment.

show abstract

Diagnostic value of American College of Radiology Thyroid Imaging Reporting and Data System combined with elastography in differentiating clinically atypical subacute thyroiditis from papillary thyroid carcinoma: a single retrospective research

Chen,

Hu,

Sun

et al. 2023

Egypt J Radiol Nucl Med

View full text Add to dashboard Cite

Background Common ultrasound imaging is hard to distinguish thyroid nodules of clinically atypical subacute thyroiditis (CAST) with papillary thyroid carcinoma (PTC). The purpose of this study was to investigate the diagnostic value of real-time elastography combined with American College of Radiology Thyroid Imaging Reporting and Data System (ACR-TIRADS) in differentiating these two lesions. Results Centripetal reduction echogenicity was only observed in the CAST nodules, with high specificity (100%) though low sensitivity (23.96%). Echogenic foci yielded good capability for differentiating PTC and CAST, with odds ratio (OR) of 36.572 and AUC of 0.788. Size and ES were independent factors to distinguish the two lesions with OR of 10.709 and 3.697, respectively. The combination of microcalcification, size < 10 mm and ES of 4 showed better AUC (0.885) than echogenic foci alone (p < 0.001). TI-RADS showed high sensitivity (91.23%) with specificity of 30.21% and AUC of 0.607 in predicting malignancy risk of PTC from CAST, while the AUC of ES and the combination of both methods were 0.508 and 0.585, respectively. Conclusions Centripetal reduction echogenicity, echogenic foci, size and ES may assist in the differential diagnosis of CAST and PTC nodules. ACR TI-RADS is superior to ES and the combination of both methods for distinguishing these two lesions.

show abstract

Subacute Thyroiditis—An Often Overlooked Sonographic Diagnosis

Cited by 3 publications

References 14 publications

Comparison of contrast-enhanced ultrasound characteristics of inflammatory thyroid nodules and papillary thyroid carcinomas using a quantitative time-intensity curve: a propensity score matching analysis

Comparison of contrast-enhanced ultrasound characteristics of inflammatory thyroid nodules and papillary thyroid carcinomas using a quantitative time-intensity curve: a propensity score matching analysis

Painful Hashimoto Thyroiditis in a 7-Year-Old Girl: Differential Diagnosis and Medical Treatment

Diagnostic value of American College of Radiology Thyroid Imaging Reporting and Data System combined with elastography in differentiating clinically atypical subacute thyroiditis from papillary thyroid carcinoma: a single retrospective research

Contact Info

Product

Resources

About