Decreased ultrasound echogenicity as a thyroid hypofunction marker and correlation with autoantibody levels
Abstract
Background/Aim. The value of ultrasound in functional disorders can be significant. That is why the question arises on the use of ultrasound examination of thyroid gland and its echogenicity as a screening method in early detection of disfunctions, of the gland primarily subclinical and clinical forms of hypothyreoidism. The objective of this paper was to determine antibodies of thyroid peroxidase (anti-TPO) and thyroglobuline antibodies (anti-TG) increase frequency in relation to the character of ultrasound echogenicity as well as to estimate the frequency of subclinically and clinically obvious hypothyreoidism in relation to the changed echogenicity. Methods. Study included 656 patients in outpatient clinic during 2014. All examinees underwent ultrasound examination of thyroid gland, the blood was taken for determination of free thyroxine (FT4), thyroid-stimulating hormone (TSH), anti-TPO and anti-TG. The patients were divided into two groups; the group A with normal echogenicity of thyroid gland tissue, and the group B with decreased echogenicity. The group B was divided into two subgroups, B1 with a mildly decreased and B2 with significantly decreased echogenicity. Results. TPO antibody, TSH and TG antibody positivity and their mean values in the group B were significantly higher, as well as in subgroups B1 and B2, in relation to the group A (p < 0.001). In the group A, only 4 (1%) examinees were indicated with subclinical hypothyreoidism. In the group B, the sublinical hypothyreoidism was indicated in 42, while the clinical hypothyreoidism was indicated in 16 examinees. Fifty-eight (25%) examinees suffered from thyroid gland altered function. In the subgroup B1, 16 examinees were indicated with subclinical and 4 with clinical hypothyreoidism. Twenty (11%) examinees suffered from altered thyroid function. In the group B2, the subclinical hypothyreoidism was found in 26 examinees, while the clinical hypothyreoidism was found in 12. Thirty-eight (76%) examinees suffered from altered thyroid function. Conclusion. The ultrasound screening of thyroid gland plays an important role in early detection of thyroid disfunction, i.e., sublinical and clinical hypothyreoidism. Decreased ultrasound echogenicity represents the significant marker of altered thyroid gland function. In these persons we have determined the high percentage of subclinical and clinical hypothyreoidism frequency.
References
Pedersen OM, Aardal NP, Larssen TB, Varhaug JE, Myking O, Vik-Mo H. The value of ultrasonography in predicting au-toimmune thyroid disease. Thyroid 2000; 10(3): 251 ̶ 9.
Rago T, Chiovato L, Grasso L, Pinchera A, Vitti P. Thyroid ultra-sonography as a tool for detecting thyroid autoimmune diseas-es and predicting thyroid dsfunction in apparently healthy sub-jects. J Endocrinol Invest 2001; 24(10): 763 ̶ 9.
Tajtakova M, Langer P, Semanova Z, Tomkova Z. Contribution of thyroid gland ultrasound for screening of patients with sus-pected subclinical thyroid gland disorders. Bratisl Lek Listy 1999; 100(4): 196 ̶ 9.
McGrogan A, Seaman HE, Wright JW, de Vries CS. The inci-dence of autoimmune thyroid disease: A systematic review of the literature. Clin Endocrinol (Oxf) 2008; 69(5): 687 ̶ 96.
Mazziotti G, Sorvillo F, Iorio S, Carbone A, Romeo A, Piscopo M, et al. Grey-scale analysis allows a quantitative evaluation of thyroid echogenicity in the patients with Hashimoto's thyroiditis. Clin Endocrinol 2003; 59(2): 223 ̶ 9.
Pearce EN, Farwell AP, Braverman LE. Thyroiditis. N Engl J Med 2003; 348(26): 2646 ̶ 55.
Vejbjerg P, Knudsen N, Perrild H, Laurberg P, Pedersen IB, Rasmussen LB, et al. The association between hypoechogenicity or irregular echo pattern at thyroid ultrasonography and thyroid function in the general population. Eur J Endocrinol 2006; 155(4): 547 ̶ 52.
Marcocci C, Vitti P, Cetani F, Catalano F, Concetti R, Pinchera A. Thyroid ultrasonography helps to identify patients with diffuse lymphocytic thyroiditis who are prone to develop hypothyroidism. J Clin Endocrinol Metab 1991; 72(1): 209‒13.
Loy M, Cianchetti ME, Cardia F, Melis A, Boi F, Mariotti S. Correlation of computerized gray-scale sonographic findings with thyroid function and thyroid autoimmune activity in patients with Hashimoto's thyroiditis. J Clin Ultrasound 2004; 32(3): 136 ̶ 40.
Bjoro T, Holmen J, Kruger O, Midthell K, Hunstad K, Schreiner T, et al. Prevalence of thyroid disease, thyroid dysfunction and thyroid peroxidase antibodies in a large, unselected population. The Health Study of Nord-trondelag (HUNT). Eur J Endocrinol 2000; 143(5): 639 ̶ 47.
Tabur S, Yasar O, Koylu A, Sabuncu T. Sensitivity and speci-ficity of ultrasonography in detecting thyroiditis. Endocrinologist 2007; 17(1): 5 ̶ 6.
Vanderpump MP, Tunbridge WM. Epidemiology and prevention of clinical and subclinical hypothyrodism. Thyroid 2002; 12(10): 839 ̶ 47.
Raber W, Gessl A, Nowotny P, Vierhapper H. Thyroid ultra-sound versus antithyroid peroxidase antibody determination: A cohort study of four hundred fifty one subjects. Thyroid 2002; 12(8): 725 ̶ 31.