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Sonographic Features of Nodular Hashimoto Thyroiditis.

Daniel Corey Oppenheimer1, Ellen Giampoli, Simone Montoya

  • 1*From the Department of Imaging Sciences, University of Rochester Medical Center; †Department of Pathology and Laboratory Medicine; and ‡Departments of Imaging Sciences, Biomedical Engineering and Urology, University of Rochester Medical Center, School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, NY.

Ultrasound Quarterly
|August 25, 2016
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Summary

Nodular Hashimoto thyroiditis (HT) commonly appears as a solid, hypoechoic nodule with a thin halo. Sonographic features of nodular HT are similar regardless of background thyroid parenchyma, whether diffuse thyroiditis or normal.

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Area of Science:

  • Endocrinology
  • Radiology
  • Pathology

Background:

  • Hashimoto thyroiditis (HT) is a common autoimmune thyroid disease.
  • Nodular HT presents diagnostic challenges, necessitating detailed sonographic analysis.
  • Understanding sonographic features aids in differentiating nodular HT from other thyroid lesions.

Purpose of the Study:

  • To characterize the sonographic features of nodular Hashimoto thyroiditis (HT).
  • To compare sonographic findings in patients with diffuse background thyroiditis versus normal background parenchyma.
  • To identify common sonographic patterns associated with nodular HT.

Main Methods:

  • Retrospective analysis of 100 thyroid nodules from 86 patients diagnosed with HT via fine-needle aspiration biopsy.
  • Review of thyroid ultrasound images obtained within one year of biopsy.
  • Evaluation of sonographic features including echogenicity, composition, halo, calcifications, and vascularity.

Main Results:

  • Nodular HT occurred in a background of diffuse thyroiditis (85%) or normal parenchyma (15%).
  • Most nodules were solid (93%) and hypoechoic (44%), often with a thin hypoechoic halo (42%) and no calcifications (96%).
  • Sonographic appearance did not significantly differ between backgrounds of diffuse thyroiditis and normal parenchyma.

Conclusions:

  • The common sonographic presentation of nodular HT is a solid, hypoechoic nodule with a thin, hypoechoic halo and no calcifications.
  • Sonographic features of nodular HT are consistent across different background thyroid parenchyma states.
  • Sonography plays a crucial role in the evaluation of nodular thyroid lesions in the context of Hashimoto thyroiditis.