Pishdad P, Pishdad G R, Tavanaa S, Pishdad R, Jalli R
Medical Imaging Research Center, Department of Radiology, Shiraz University of Medical Sciences, Shiraz, Iran.
Endocrine and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
J Biomed Phys Eng. 2017 Mar 1;7(1):21-26. eCollection 2017 Mar.
Graves' disease and Hashimoto's thyroiditis are the most common causes of hyper and hypothyroidism, respectively. Differentiation of these 2 diseases, if the patient is euthyroid, may sometimes be extremely difficult on the basis of clinical and laboratory findings. The purpose of this study was to determine the sensitivity and specificity of gray scale sonography in differentiation of Graves' disease from Hashimoto's thyroiditis.
This study included 149 patients divided into three groups, patients with Graves' disease (34 patients, mean age = 36.8 ± 10.17 years), Patients with Hashimoto's thyroiditis (62 patients, mean age = 33.4 ± 12.16 years) and control group (53 healthy people, mean age = 34.74 ± 16.87 years). Members of all groups were referred to a single radiologist for thyroid sonography for evaluation of thyroid echogenicity pattern.
A total of 117 women and 32 men were examined by sonography. The most common sonographic pattern in Hashimoto and Graves' was homogenous hypo-echogenicity which was observed in 45.2% and 47.1% of cases, respectively. Peripheral hypo-echogenicity pattern was seen in 40.3% of Hashimoto's group with 100% specificity and 40.3% sensitivity. Central-hypoechogenic pattern was observed in 17.6% of Graves' group with 100% and 17.6% specificity and sensitivity, respectively.
Our findings indicate that sonography has high specificity but low sensitivity in the diagnosis of either Graves' disease or Hashimoto's thyroiditis. It is therefore not possible to differentiate between these two diseases using sonography alone. Confirmation by laboratory data is also needed.
格雷夫斯病和桥本甲状腺炎分别是甲状腺功能亢进和减退的最常见病因。对于甲状腺功能正常的患者，有时基于临床和实验室检查结果很难区分这两种疾病。本研究的目的是确定灰阶超声在区分格雷夫斯病和桥本甲状腺炎方面的敏感性和特异性。
本研究纳入149例患者，分为三组，格雷夫斯病患者（34例，平均年龄 = 36.8 ± 10.17岁）、桥本甲状腺炎患者（62例，平均年龄 = 33.4 ± 12.16岁）和对照组（53名健康人，平均年龄 = 34.74 ± 16.87岁）。所有组的成员均被转诊至一名放射科医生处进行甲状腺超声检查，以评估甲状腺回声模式。
共有117名女性和32名男性接受了超声检查。桥本甲状腺炎和格雷夫斯病最常见的超声模式是均匀低回声，分别在45.2%和47.1%的病例中观察到。外周低回声模式在桥本甲状腺炎组的40.3%患者中可见，特异性为100%，敏感性为40.3%。中央低回声模式在格雷夫斯病组的17.6%患者中观察到，特异性和敏感性分别为100%和17.6%。
我们的研究结果表明，超声在诊断格雷夫斯病或桥本甲状腺炎方面具有高特异性但低敏感性。因此，仅使用超声无法区分这两种疾病。还需要实验室数据进行确诊。
