橋本甲狀腺炎

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1、The ultrasonic diagnosis of Hashimoto thyroiditisTutor:ZhengMin Speaker:WangLing Introduction Clinical manifestations Ultrasound performance Differential diagnosis Summary Hashimoto thyroiditis also called chronic Hashimoto thyroiditis also called chronic lymphocytic thyroiditis,Japanese scholars ly

2、mphocytic thyroiditis,Japanese scholars Hashimoto Hashimoto reported firstly according to the histologic according to the histologic features features ，that is the most mon one of autoimmune that is the most mon one of autoimmune thyroid diseases.HT disease slowthyroid diseases.HT disease slowlyly,c

3、linical,clinical manifestationmanifestation is not is not very typical;And the course very typical;And the course of a long,pathological changes and thyroid of a long,pathological changes and thyroid function state performance is differfunction state performance is differentent,so the ,so the ultras

4、onography findings ultrasonography findings is is plex.plex.From 80%to 90%patients mainly manifested as thyroid diffuse enlargement of asymmetry,thyroid texture tough such as rubber sample,with the surrounding tissue without adhesion.The late course is more nodular or atrophy.Early may have hyperthy

5、roidism performance；Late hypothyroidism,May be due to thyroid atrophy performance for myxedema,impotent and so on.thyroid diffuse enlargement of asymmetry,isthmus is obvious.The internal echo reduction,uneven distribution.The visible thin wire-like or coarse network-like strong echo .Two dimensional

6、 ultrasonography Local HT is relatively rare,that is a special type,early manifest.Such as effectively and timely treatment,prognosis and oute is betterUltrasonography is one side or both side lobe of thyroid own single or multiple uneven and hypoechoic zone,boundary clear,form owe rules,like“patter

7、n”,space occupying lesion effect is not obvious.Echo Unevenness type:Normal thyroid volume or biger,multiple uneven,Increasing coarse or fine wire sample strong echo.Patch type:Normal thyroid volume or biger,diffused distribution sheet hypoecho.Diffuse type:Thyroid volume increase,Essence is diffuse

8、 type echo reduce.Nodules type:Thyroid volume increase,diffuse distribution ranging from the size of the high、low or equal echo.回聲不均型回聲不均型：甲狀腺球蛋甲狀腺球蛋白抗體（白抗體（TGA）陽性，）陽性，T3、T4、TSH正常正常斑片型斑片型彌漫型彌漫型結節型結節型 Ultrasonic found tracheal side swollen lymph nodes,Is autoimmune thyroid disease more specific ultra

9、sonic one of the signs,manifest:Thyroid isthmus front,bilateral leaf under round or oval echoic,morphological rules,part of the skin medulla boundary clear.early period:essence Blood flow signal rich,Even the inferno sign,PSV rise,Prompt hyperthyroidism or normal.With the progress of the disease:The

10、 rich blood flow significantly lower level,PSV dropped even lower than normal,Prompt typothyroidism.later period:Blood flow signal significantly reduced,velocity obviously reduced,Prompt Thyroid function significantly impaired.HT flow signal most significantly increased-fire syndrome,The signs may o

11、ccur early hyperthyroidism stage,also be found in the late hypothyroidism stage,This note should notice thyroid PSV,and bine thyroid function tests.Subacute thyroiditisNodular goiterHyperthyroidism Thyroid profile is normal or increased，seen in sheet hypoechoic area，more irregular，rear echo slightly

12、 enhanced，the isthmus is no obvious thickening。CDFI：blood flow is rich surrounding hypoechoic area，but internal flow signals is fewer or no Signal。Subacute thyroiditis The former increase mainly about the size of thyroid，the latter increase mainly anteroposterior diameter，Isthmus thickening，an inter

13、nal network or a cord-like echogenic。Hyperthyroidism Two dimensional ultrasonography：Thyroid solitary or multiple nodules，Vary in size、Echo diversification，CDFI：Blood flow signal occurring in between nodule，but Nodules in the peripheral and intranodular blood flow signal less.Nodular goiter HT ultra

14、sonography has certain characteristics,in the diagnosis and differential diagnosis of clinical significance.In view of the long course of disease,orbidity,with plicated clinical manifestations,its sonographic appearances are also different,still needed to be bined with clinical and laboratory examinations considering.HT has plicated with thyroid cancer,on the basis of HT found hypoechoic nodules or calcification,should be considered,so as to avoid misdiagnosis.