The Value Of Ultrasound Elastography In Evaluating The Damage Degree Of Thyroid In Patients With Hashimoto’s Thyroiditis

ObjectiveThe pathological basis of Hashimoto’s thyroiditis(HT)is the infiltration of a large number of lymphocytes and the proliferation of connective tissue,which leads to thyroid fibrosis.This study aims to explore the role of elastography in evaluating the extent of thyroid parenchymal damage in HT patients.Methods103 HT patients who were treated in our hospital from May 2019 to April2020 were selected as the case group.According to the characteristics of conventional ultrasound images,those subjects were divided into focal type,nodular type,diffuse echo reduction type,and diffuse echo enhancement type.103 patients were divided into normal thyroid function,hyperthyroidism,subclinical hypothyroidism,and clinical hypothyroidism according to thyroid function.During the same period,53 healthy volunteers were selected as the control group.All subjects underwent five laboratory tests of thyroid function,routine ultrasound and ultrasound elastography.The differences of elastography between normal control group and case group were compared.The differences of thyroid elastography strain ratio between normal control group and four ultrasound types of HT were compared.The differences of thyroid elastography strain ratio between normal control group and different clinical stages of HT were compared.The differences in strain ratio of thyroid elastography between different ultrasound classification HT of the same clinical stage were compared.The correlation between the strain ratio of thyroid elastography in HT patients,glandular leaf thickness,isthmus thickness,serum specific antibody(Tg Ab,TPOAb)titer,and blood flow grade were analyzed.Results1.Laboratory and routine ultrasound examination resultsAmong 103 HT patients,60 cases(58.3%)with normal thyroid function(only increased serum specific antibodies)and 33 cases(32%)with subclinical hypothyroidism.Conventional ultrasound focal type is mostly normal of thyroid function(69.6%).Nodular type,mostly with normal thyroid function(59%).Diffuse echo reduction type is mostly subclinical hypothyroidism(70%).Diffuse echo enhancement type,mostly with normal thyroid function(76.2%).2.Strain elastography results(1)The difference in strain ratio between the normal control group and the HT patients(case group)was statistically significant(P<0.001).(2)HT diffuse echo reduction type,HT nodular type,HT diffuse echo enhancement type,HT focal type,and normal control group strain ratio were sequentially reduced(P<0.001).(3)Excluding clinical hypothyroidism(only 1 case),the strain ratio of HT subclinical hypothyroidism,hyperthyroidism,normal thyroid function and normal control group were sequentially reduced(P<0.001).3.The relationship and difference between HT clinical staging and ultrasound classification(1)The difference in strain ratio between different ultrasound classifications in the HT normal thyroid function was statistically significant(P<0.001).(2)The difference in strain ratio between different ultrasound classifications in the HT subclinical hypothyroidism was statistically significant(P<0.001).4.Correlation between HT thyroid strain ratio and various indicatorsThyroid strain ratio in HT patients was correlated with glandular leaf thickness,blood flow grade,serum TPOAb titer,and isthmus thickness,but no correlation with serum Tg Ab titer.ConclusionsHT can lead to an increase in thyroid stiffness.Ultrasound elastography can sensitively detect changes in thyroid stiffness to evaluate the degree of thyroid damage in different stages of HT,providing a basis for clinical treatment and observation,and has certain application value.