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Ultrasonography as a tool for detecting autoimmune thyroid diseases and predicting thyroid dysfunction

Autoimmune thyroid diseases (AITD) - (thyroiditis Hashimoto and Graves’ disease) are associated with the typical echographic presentation: diffuse reduction in thyroid echogenity, or hypoechogenic areas within normal ehogenity of the thyroid parenchyma, ehogenic stripes within thyroid, irregular contours of the lobes, and slightly enlarged lymph nodes near the thyroid. Sometimes, only some of these typical signs are presented, or the presence of these signs is very discreet. Colour Doppler ultrasonography is an additional tool for studying thyroid vascularity and blood flow parameters for predicting activity of the disease. Material and methods: The 1228 subjects, referred for ultrasonography of the thyroid, were examined prospectively with regard to detecting AITD. The reason for referral for ultrasasonography of 862 patients was diffuse goiter, thyroid dysfunction (TD), or neck discomfort, but 366 of apparently healthy subjects referred for general check-up, were included in this study, also. Determination of T4, T3, TSH, TPOAb and TgAb was performed. Results: In 319 subjects with normal thyroid echostructure, normal thyroid vascularity and normal values of blood flow parameters, elevated TPOAb levels were observed in 3, 4% and elevated TSH levels in 0, 9% of patients. In 593 patients with typical echographic presentation for AITD, elevated TPOAb levels were observed in 90%. In the same group TD was found in 450 patients (76 %). In the third group of 107 patients, based on some discreet echographic signs when an AITD can be suspected only, elevated TPOAb levels were observed in 69% and TD was found in 33%. Thyroid nodules were observed in 34% of patients with AITD. Conclusion: Ultrasonograpy is a very useful tool for detecting AITD and subclinical TD, even when only some of discreet echograpic signs are presented. Ultrasound guided fine-needle aspiration biopsy is not necessary for diagnosis of AITD but it is helpful in making the diagnosis in thyroid nodules associated with AITD.

Ultrasonogrphy; Autoimmune Thyroid Diseases

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