Learning objectives
The purpose of this educational exhibit is to:
1- Discuss the most common sonographic (US) findings of the autoimmune thyroid diseases (AITD) and correlate them with the two major subtypes: Graves disease (GD) and Hashimoto thyroiditis (HT).
2- Demonstrate in a case based series how US evaluation can help in the differential diagnosis of the AITD.
3- Discuss the role of US in the follow up evaluation of AITD.
Background
AITD arethe most common organ-specific autoimmune disorders affecting up to 5% of the Western population.
Clinical and laboratorial findings usually allow differentiation between the two major subtypes of AITD.
However,
in some cases these findings may overlap,
which makes thedefinitive diagnosis challenging.
In this scenario thyroid gland sonography appears a useful diagnostic tool toestablish the differential diagnosis.Accordingly,
a growing demand for ultrasound has been observed and so this method has been included as routinescreening for women in some countries.
Additionally,
ultrasound technological developments allow the...
Findings and procedure details
The US examination should begin with the patient in supine position,
with a pillow placed under their shoulders and hyperextend neck.
Ultrasound gel is applied over the thyroid area.
The transducer isdirectly placed on the skin over the thyroid gland and images of each lobe are obtained in transverse and longitudinal planes.
Craniocaudal and sagittal dimensions of both lobes are measured on the longitudinal image.
The transverse dimension ismeasured on the transverse image.
The thyroid gland volume iscalculated using the formula: Volume = length x...
Conclusion
Sonographicevaluation of thyroid gland has an important role in the differential diagnosis of AITD subtypes.
The correlation of the ultrasonographic findings with clinical and laboratory information is essential to establish an accurate diagnosis.
References
1-Weetman,
A.P.
(2000) Graves’ Disease.
The New England Journal of Medicine,
343,
1236-1248.
http://dx.doi.org/10.1056/NEJM200010263431707
2-Davies,
T.F.
(1992) New Thinking on the Immunology of Graves’ Disease.
Thyroid Today,
15,
1-11.
3-Graves,
R.J.
(1835) Newly Observed Affection of the Thyroid.
London Medical and Surgical Journal,
7,
515.
4- Zuhur,
S.S.,
Ozel,
A.,
Kuzu,
I.,
Erol,
R.S.,
Ozcan,
N.D.,
Okcan,
B.,
Yenici,
F.U.
and Altuntas,
Y.
(2013) The Diagnostic Utility of Color Doppler Ultrasonography,
Tc-99m Pertechnetate Uptake and TSH Receptor Antibody for Differential Diagnosis between Graves’ Disease and...