Sonography of Hashimoto's thyroiditis

Area of Science:

• Endocrinology
• Radiology
• Pathology

Background:

• Hashimoto's thyroiditis is an autoimmune disease affecting the thyroid gland.
• Thyroid echogenicity on ultrasound can provide diagnostic information.
• Understanding the relationship between echogenicity and thyroid function is crucial for patient management.

Observation:

• Fifty-three untreated Hashimoto's thyroiditis patients were stratified into two groups based on thyroid echogenicity.
• Group A (25 patients) exhibited thyroid echogenicity similar to or less than adjacent muscles.
• Group B (28 patients) showed normal or higher thyroid echogenicity compared to muscles.

Findings:

• Group A patients demonstrated significantly lower mean T4 levels compared to Group B.
• Abnormally low T4 and high TSH levels were more frequent in Group A.
• Severe degeneration and disappearance of thyroid follicles were observed in all Group A cases, contrasting with generally normal-sized follicles in Group B.

Implications:

• Thyroid hypoechogenicity is a significant indicator of hypothyroidism in Hashimoto's thyroiditis.
• Ultrasound-detected hypoechogenicity correlates with severe thyroid follicular damage.
• This finding aids in assessing disease severity and guiding clinical decisions.