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1、The ultrasonic diagnosis of Hashimoto thyroiditis,Tutor:ZhengMin Speaker:WangLing,IntroductionClinical manifestationsUltrasound performanceDifferential diagnosisSummary,Hashimoto thyroiditis also called chronic lymphocytic thyroiditis,Japanese scholars Hashimoto reported firstly according to the his
2、tologic features，that is the most mon one of autoimmune thyroid diseases.HT disease slowly,clinical manifestation is not very typical;And the course of a long,pathological changes and thyroid function state performance is different,so the ultrasonography findings is plex.,Introduction,From 80%to 90%
3、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 hyperthyroidism performance；Late hypothyroidism,May be due to thyroid atrophy perf
4、ormance for myxedema,impotent and so on.,Clinical manifestation,Ultrasonographic characteristics,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 ultrasonography,
5、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“pattern”,space occupyin
6、g 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 type echo reduc
7、e.Nodules type:Thyroid volume increase,diffuse distribution ranging from the size of the high、low or equal echo.,Classification,回声不均型：甲状腺球蛋白抗体（TGA）阳性，T3、T4、TSH正常,斑片型,弥漫型,结节型,Ultrasonic found tracheal side swollen lymph nodes,Is autoimmune thyroid disease more specific ultrasonic one of the signs,man
8、ifest: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 rich blood flow signific
9、antly 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.,CDFI,HT flow signal most significantly increased-fire syndrome,The signs may occur early hyperthy
10、roidism stage,also be found in the late hypothyroidism stage,This note should notice thyroid PSV,and bine thyroid function tests.,Subacute thyroiditisNodular goiterHyperthyroidism,Differential diagnosis,Thyroid profile is normal or increased，seen in sheet hypoechoic area，more irregular，rear echo sli
11、ghtly 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
12、 internal network or a cord-like echogenic。,Hyperthyroidism,甲亢,桥本,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 g
13、oiter,HT ultrasonography 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.,summary,谢谢大家！,
