Abstract
Aim: The aim of study was to validate the grey scale sonographic findings in lymphocytic thyroiditis using fine needle aspiration cytology which is taken as reference standard.
Methodology: 89 patients with diffuse neck swelling of the age group 18-80 years who came for sonographic examination of thyroid in the Department of Radiodiagnosis, in Medical college Alappuzha were included in the study, for a period of one year. Grey scale evaluation was done followed by ultrasound guided fine needle aspiration cytology.
Study Design: Descriptive study, with diagnostic test evaluation.
Results: The results indicated that there can be sonographically normal forms of thyroiditis, and also it not associated with thyroid enlargement always. The reduction in echogenicity correlated with reduction in thyroid follicles, which is due to lymphocytic infiltration in lymphocytic thyroiditis. A combination of grayscale parameters, presence of micronodules, fibrotic septations and absence of calcification can diagnose thyroiditis with sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 85%, 70%,88%,64% and 80% respectively. New cut off value of 1.2 cm, for anteroposterior diameter of thyroid is obtained from the receiver operator characteristic curve which can diagnose lymphocytic thyroiditis with 70% sensitivity and 60% specificity.
Keywords: Lymphocytic Thyroiditis, ultrasound thyroid.
References
1. Vaishali Deshmukh, Anish Behl, Vagesh Iyer, Harish Joshi, Jayashree P. Dholye, Prema K. Varthakavi. Prevalence, clinical and biochemical profile of subclinical hypothyroidism in India. Indian Journal of Endocrinology and Metabolism. 2013 may- June; 17(3).
2. Hemlata T Kamra1, Ruchi Agarwal2, Parveen Rana3, Rajnish Kalra4, Swarn Kaur5. Evaluation Profile of Thyroid Nodule by FNAC in the Rural Population of Khanpur Kalan, Sonepat, Haryana. Journal of Clinical and Diagnostic Research. 2014 oct; 8(10)(FC16-FC18).
3. Anderson L, Middleton WD, Teefey SA, Reading CC, Langer JE. Part 2, sonogr-aphic analysis of benign and malignant nodules associated with lymphocytic thyroiditis. 2010;(195).
4. Marcocci C, Vitti P, Cetani F, Catalano F, Concetti R. Thyroid ultrasonography helps to identify patients with diffuse lymphocytic thyroiditis who are prone to hypothyroidism. J Clin Endocrinol metab. 1993; 72(209-213).
5. Anderson L, Middleton W, Teefey S A,Reading C C,Langer J E et al. Hashi-moto Thyroiditis: Part 1, sonographic analysis of the nodular form of hashimoto thyroiditis. 2010; 195.
6. Yeh H C, Futterweit W, Gilbert P. Micronodulation: ultrasonographic sign of Hashimoto’s thyroiditis. j ultrasound med. 1996; 15(813-819).
7. Bogazzi F, Bartalena L, Brogioni S, Burelli A, Manetti L, Tanda ML, et al. Thyroid vascularity and blood flow are not dependent on serum thyroid hormone levels: studies in vivo by color flow Doppler sonography. 1999; 140(5).
8. Pedersen OM, Aardal NP, Larssen TB et al. The value of ultrasonography in predicting autoimmune thyroid disease. eur thyroid j. 2000; 10(251-259).
9. Isin Ceylan, SerkanYener, Firat Bayraktar, Mustafa Secil. Roles of ultrasound and power Doppler ultrasound for diagnosis of Hashimoto thyroiditis in anti-thyroid marker-positive euthyroid subjects. Quantitative Imaging in Medicine and Surgery. 2014 august; 4(4)(232-238).
10. Sena Hwang1, Dong Yeob Shin, Eun Kyung Kim, Woo Ick Yang, Jung Woo Byun. Focal Lymphocytic Thyroiditis Nodules Share the Features of Papillary Thyroid Cancer on Ultrasound. Yonsei Med J 2015 Sep;56(5):1338-1344. 2015 sep; 56(5)(1338-1344).
11. Türker Acar, SühaSüreyya Özbek, Mehmet Erdoğan, Ahmet Gökhan Özgen, Selçuk Orhan Demirel. US findings in euthyroid patients with positive antithyroid autoantibody tests compared to normal and hypothyroid cases. Turkish society of radiology. 2013; 19(265-270).