Eftekharian Fatemeh, Ranjbar Omrani Gholamhossein, Dabbaghmanesh Mohammad Hossein, Sahraei Reza, Behnam Mohammad Ali, Bakhshayeshkaram Marzieh, Dabbaghmanesh Mohammad Mahdi
Endocrinology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Internal Medicine Department, Jahrom University of Medical Sciences, Jahrom, Iran.
Galen Med J. 2024 Jul 28;13:e3309. doi: 10.31661/gmj.v13i.3309. eCollection 2024.
Ultrasound examination of the thyroid has emerged as a useful diagnostic and prognostic tool, along with measuring serum titers of anti-thyroid peroxidase (TPO), anti-thyroglobulin (Tg), and thyroid hormones, in patients with Hashimoto's thyroiditis. So, we aimed at considering correlations of ultrasonographic, antibodies, and thyroid hormone levels.
A total of 149 patients (118 females, 31 males; aged 18-60 years; mean age: 38.60 ± 8.03 years) who were diagnosed with Hashimoto's thyroiditis were enrolled in the study. The blood sample was taken to measure serum titers of free T3 (FT3) and T4 (FT4), TSH, anti-TPO, and anti-Tg antibody titers. The thyroid sonography of each patient was classified into one of the five grades by real-time ultrasound (US) based on echogenicity, thyroid size, and thyroid pattern. We evaluated whether there was a correlation between thyroid characteristics observed via ultrasound and serum levels of thyroid hormones, anti-TPO antibodies, and anti-Tg antibodies.
Nodular structures were detected in 54 (36.2%) patients (38 micro-nodular and 16 macro-nodular). Echogenicity was recorded as isoechoic in 15(10.07%) and hypoechoic in 119 (79.87%) subjects. Euthyroid subjects had significantly thicker isthmus than overt and subclinical hypothyroid patients (P=0.018). Mean serum TSH, anti-Tg, and anti-TPO antibody titers showed a significant increase in patients with macro-nodules compared to those with micro-nodules and individuals without nodules (P0.05). The thickness of the isthmus had a significant negative correlation with FT4 (P=0.046; r=0.11) and FT3 (P=0.017; r=0.15), respectively. Thyroid autoantibodies had positive significant correlations with different parameters of thyroid volume (P0.05).
Thyroid US findings, in addition to serum anti-Tg and anti-TPO antibody titers, might be correlated with the severity and extent of Hashimoto's thyroiditis, but further evaluations are needed.
对于桥本甲状腺炎患者，甲状腺超声检查已成为一种有用的诊断和预后工具，同时还可测量抗甲状腺过氧化物酶（TPO）、抗甲状腺球蛋白（Tg）的血清滴度以及甲状腺激素水平。因此，我们旨在探讨超声检查结果、抗体水平与甲状腺激素水平之间的相关性。
本研究共纳入149例诊断为桥本甲状腺炎的患者（118例女性，31例男性；年龄18 - 60岁；平均年龄：38.60±8.03岁）。采集血样以测量游离T3（FT3）、T4（FT4）、促甲状腺激素（TSH）、抗TPO及抗Tg抗体滴度。根据回声、甲状腺大小和甲状腺形态，通过实时超声（US）将每位患者的甲状腺超声检查结果分为五个等级之一。我们评估了超声观察到的甲状腺特征与甲状腺激素、抗TPO抗体和抗Tg抗体血清水平之间是否存在相关性。
54例（36.2%）患者检测到结节结构（38个微结节和16个大结节）。15例（10.07%）受试者的回声记录为等回声，119例（79.87%）为低回声。甲状腺功能正常的受试者峡部明显比显性和亚临床甲状腺功能减退患者厚（P = 0.018）。与微结节患者和无结节个体相比，大结节患者的平均血清TSH、抗Tg和抗TPO抗体滴度显著升高（P < 0.05）。峡部厚度分别与FT4（P = 0.046；r = 0.11）和FT3（P = 0.017；r = 0.15）呈显著负相关。甲状腺自身抗体与甲状腺体积的不同参数呈显著正相关（P < 0.05）。
除血清抗Tg和抗TPO抗体滴度外，甲状腺超声检查结果可能与桥本甲状腺炎的严重程度和范围相关，但仍需进一步评估。
