The Value Of Color Doppler Ultrasound In Hashimoto's Thyroiditis With Hypothyroidism

Objective:To research the ultrasonic features of hashimoto's thyroiditis (HT) with hypothyroidism and discussion the value of color doppler in hashimoto's thyroiditis with hypothyroidism.Methods:Ultrasonography was performed in 205 patients who were diagnosed as having HT from 2010-7 to 2011-2. The patients were classified into three groups according to thyroid function, the first group consisted of 65 patients with hyperthyroidism,the second group consisted of 100 patients with hypothyroidism and the third group consisted of 40 patients with euthyroidism. Ultrasonography (Esaote, Mylab 90, Italy) was performed using high-frequency linear-array transducer (5～13MHz). The magnitude of thyroid gland and the diameter of superior thyroid arteries, the sonographic features of thyroid gland were evaluated by gray scale sonography; subsequently color Doppler flow imaging(CDFI) was used to measure the acceleration, the acceleration time, the peak systolic velocity(PSV),end of diastolic velocity(EDV), pulsatility index and resistance index (RI) of thyroid artery.Results:1)The width, thickness of the lateral lobe and the thickness of the isthmic portion in HT hyperthyroidism and HT euthyroidism increase than those in the normal control. But the HT hypothyroidism decrease than those in the normal control. There was a significant difference (P<0.05) between the thicknesses of the gland in each group. The length in the HT hyperthyroidism group was greater than that in the others.2) Focal hypoechoic pattern and diffuse hypoechoic pattern were mainly seen in the groups of HT hyperthyroidism and HT euthyroidism, diffuse hypoechoic pattern with heterogeneous linear hyperechoic and nodular changes were mainly seen in the HT hypothyroidism group.3) Normal subjects had CDFI pattern 0 (absent or minimal intraparenchymal spots). Patients with HT euthyroidism had CDFI pattern 0 and patternⅠ(presence of parenchymal blood flow with patchy uneven distribution). Patients with HT hypothyroidism had CDFI patternⅠand patternⅡ(mild increase of color flow Doppler signal) except two cases no blood signal. Patients with HT hyperthyroidism had CDFI patternⅡand patternⅢ(marked increase).4) There was a significant difference (P<0.05) between the acceleration and the acceleration time in each group. There was a significant difference (P<0.05) between the PSV of the thyroid artery.The RIs and PIs in the three HT groups was respectively greater than thin the normal control. There were no significant differences among the three HT groups by compared with each other.5) The PSV in the HT hypothyroidism was related with serum TSH levels (P<0.05).Conclusions:To some extent, color Doppler ultrasound can be used to evaluate the thyroid function of Hashimoto's thyroiditis. The acceleration and the acceleration time are valuable in the spectrum of thyroid artery. Especially the sensitivity and specificity of the HT with hyperthyroidism and hypothyroidism are clearly distinguished from the acceleration and the acceleration time of spectrum.