Hashimoto Thyroiditis: Part 2, Sonographic Analysis of Benign and Malignant Nodules in Patients With Diffuse Hashimoto Thyroiditis

Anderson, Lauren; Middleton, William D.; Teefey, Sharlene A.; Reading, Carl C.; Langer, Jill E.; Desser, Terry S.; Szabunio, Margaret M.; Mandel, Susan J.; Hildebolt, Charles F.; Cronan, John J.

doi:10.2214/ajr.09.3680

Cited by 84 publications

(59 citation statements)

References 27 publications

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“…Low-echoic halo, a hypoechoic rim surrounding the outer margin of a nodule, can represent a tumor capsule, a fibrotic pseudocapsule, compressed normal thyroid tissue, or chronic inflammatory infiltrates. 16,18 These features may be common to benign lesions, [19][20][21] a finding supported by our results. Our study had several limitations, including its retrospective design and the small number of patients, which may have introduced a selection bias.…”

supporting

confidence: 90%

Collapsing Benign Cystic Nodules of the Thyroid Gland: Sonographic Differentiation from Papillary Thyroid Carcinoma

Jeong²,

Shong³

et al. 2011

AJNR Am J Neuroradiol

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supporting

confidence: 90%

Collapsing Benign Cystic Nodules of the Thyroid Gland: Sonographic Differentiation from Papillary Thyroid Carcinoma

Jeong²,

Shong³

et al. 2011

AJNR Am J Neuroradiol

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“…Thyroglobulin antibody (TgAb) and/or thyroid peroxidase (TPOAb) antibody positiveness is used for the diagnosis of HT. Ultrasonography demonstrates decreased echogenicity, heterogeneity, hypovascularity, and the presence of hypoechoic micronodules in patients with HT (19).…”

Section: Chronic Autoimmune Thyroiditismentioning

confidence: 94%

Value of Real-Time and Strain Ratio Elastography in Differential Diagnosis of Graves’ Disease and Subacute and Hashimoto’s Thyroiditis

Korkmaz¹,

Baki²,

Köse³

et al. 2017

Iran J Radiol

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Objectives: The main purpose of the present study was to determine the efficacy of real-time elastography (RTE) and strain elastography (STE) in the diagnosis of different thyroid diseases. We also aimed to calculate the cut-off points for the differential diagnosis of subacute thyroiditis (SAT), Graves' disease (GD), and Hashimoto's thyroiditis (HT), which have a similar B-mode sonographic appearance. Patients and Methods: A total of 24 patients with GD (10.9%), 94 patients with HT (42.7%), 20 patients with SAT (9.1%), and 82 individuals with normal healthy thyroids (37.3%) were included. Grayscale ultrasound evaluation of thyroid glands was performed with standard transverse and longitudinal planes before sonoelastography. Results:The strain ratios (SRs) (mean ± standard deviation) of patients with GD, HT, and SAT, and the control group (CG) were 14.7 ± 14.8, 8.4 ± 9.6, 23.2 ± 10.8, and 1.37 ± 0.8, respectively. The cut-off points of strain elastography of the patients with GD, HT, and SAT to the CG were 2.69 (sensitivity 92%, specificity 90%, area under the curve (AUC) 0.983; 95% CI), 2.18 (sensitivity 100%, specificity 85%, AUC 0.898), and 5.54 (sensitivity 100%, specificity 100%, AUC 1.000; 95% CI), respectively. The cut-off point of the strain ratios (SR) of the total amount of patients with HT and GD to SAT was 14.79 (sensitivity 80%, specificity 85%, AUC 0.869; 95% CI). Conclusion: Statistically significant differences were noted in the SR values and elasticity scores of the three experimental groups, and the CG. The elasticity scores of the SAT and HT groups were not significantly different from those of the GD group. The diagnostic performance of strain ratio elastography (P < 0.0001) was higher than that of real time elastography (P < 0.001). In terms of differentiating diagnosis, ES could differentiate SAT from HT, but it had no value in differentiating GD from HT and SAT. We also found statistically significant SRs for the differential diagnosis of SAT from GD and HT. Strain elastography could be a useful method for the differential diagnosis of SAT from a healthy population or from other types of thyroiditis such as GD and HT.

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“…Given the hypoechogenicity, specific echostructure and increased vascularity of HT, it seems reasonable to question whether existing guidelines are appropriate for this particular patient population [32]. No individual US parameter is suitable for preoperative diagnosis of malignancy in HT.…”

Section: Prace Oryginalnementioning

confidence: 99%

Clinical, ultrasonographical and histopathological aspects in Hashimoto’s thyroiditis associated with malignant and benign thyroid nodules

Zosin¹,

Balaş²

2013

Endokrynologia Polska

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Intriduction: The reported prevalence of chronic autoimmune thyroiditis associated with differentiated thyroid cancer (DTC) is heterogeneous. The aim of this study was to evaluate some epidemiological, clinical, sonographical and histological features of operated thyroid nodules with background diffuse autoimmune thyroiditis. Material and methods:The study included 411 cases with Hashimoto's thyroiditis (HT), of which 118 presented thyroid nodular disease (TND). Thyroidectomy was performed in 76 cases. Of these patients, 24 presented histologically confirmed DTC and 52 benign lesions. DTC types were as follows: papillary thyroid cancer (PTC) (n = 6), follicular variant of PTC (FVPTC) (n = 6), papillary microcarcinomas (n = 8), follicular thyroid carcinoma (n = 1) and the mixed form (classic PTC and FVPTC) (n = 3). The benign nodules were dominated by: follicular adenoma (48%), and colloid goitre (40.3%). Results:The sonographic features with predictive risk for malignancy in cases with HT associated with TND were represented by: solid composition, hypoechogenicity and microcalcifications. The characters of margins, the nodular shape and the type of vascularity do not seem to be as useful for identification of malignant nodules in HT. Fine needle-aspiration biopsy (FNAB) showed in DTC cases different cytological smears: malignant (ten), indeterminate (eight), benign (two), and non-diagnostic (four). In the group of benign nodules, the indeterminate smears represented also a significant percentage (n = 12). Conclusions: The incidence of TND associated with HT was 28.7%. Among 76 operated cases, 31.5% presented DTC. The accuracy of FNAB in the preoperative diagnosis showed higher sensitivity (90.0%) and specificity (61.5%) compared to sonographic criteria. StreszczenieWstęp: Podawane w literaturze dane na temat rozpowszechnienia przewlekłego autoimmunologicznego zapalenia tarczycy związanego ze zróżnicowanym rakiem tarczycy (DTC, differentiated thyroid cancer) cechuje duża rozpiętość. Celem badania była ocena wybranych cech epidemiologicznych, klinicznych, ultrasonograficznych i histopatologicznych operowanych guzków tarczycy u pacjentów z rozlanym autoimmunologicznym zapaleniem tarczycy. Materiał i metody: Do badania włączono 411 przypadków choroby Hashimoto (HT, Hashimoto thyroiditis), z czego 118 pacjentów zgłosiło się do lekarza z powodu choroby guzkowej tarczycy (TND, thyroid nodular disease). Tyroidektomię wykonano u 76 pacjentów, przy czym u 24 pacjentów badanie histopatologiczne wykazało DTC, a u pozostałych 52 -zmiany łagodne. Postacie DTC były następujące: rak brodawkowaty tarczycy (PTC, papillary thyroid cancer) (n = 6), wariant pęcherzykowy PTC (FVPTC, follicular variant of papillary thyroid cancer) (n = 6), mikroraki brodawkowate (n = 8), rak pęcherzykowy tarczycy (n = 1) i postać mieszana (klasyczny PTC i FVPTC) (n = 3). Większość guzków łagodnych stanowiły gruczolaki pęcherzykowe (48%) i wole koloidalne (40,3%). Wyniki: Cechy ultrasonograficzne związane z ryzykiem rozpoznania nowotworu złośl...

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Hashimoto Thyroiditis: Part 2, Sonographic Analysis of Benign and Malignant Nodules in Patients With Diffuse Hashimoto Thyroiditis

Cited by 84 publications

References 27 publications

Collapsing Benign Cystic Nodules of the Thyroid Gland: Sonographic Differentiation from Papillary Thyroid Carcinoma

Collapsing Benign Cystic Nodules of the Thyroid Gland: Sonographic Differentiation from Papillary Thyroid Carcinoma

Value of Real-Time and Strain Ratio Elastography in Differential Diagnosis of Graves’ Disease and Subacute and Hashimoto’s Thyroiditis

Clinical, ultrasonographical and histopathological aspects in Hashimoto’s thyroiditis associated with malignant and benign thyroid nodules

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