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Grey‐scale analysis allows a quantitative evaluation of thyroid echogenicity in the patients with Hashimoto's thyroiditis
Author(s) -
Mazziotti Gherardo,
Sorvillo Francesca,
Iorio Sergio,
Carbone Antonella,
Romeo Antonio,
Piscopo Marco,
Capuano Salvatore,
Capuano Ermanno,
Amato Giovanni,
Carella Carlo
Publication year - 2003
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1046/j.1365-2265.2003.01829.x
Subject(s) - echogenicity , medicine , thyroid , thyroid peroxidase , endocrinology , thyroiditis , thyroglobulin , gastroenterology , pathology , ultrasound , radiology
Summary objective In the present study we have performed a grey‐scale quantitative analysis of thyroid echogenicity in the patients affected by Hashimoto's thyroiditis (HT), obtaining a numerical estimate of the degree of hypoecogenicity associated with the appearance of thyroid dysfunction. materials and methods The study group included 89 patients with serum positivity for thyroglobulin (TgAb) and/or peroxidase (TPOAb) antibodies. Ultrasound (US) evaluation of thyroid gland and biochemical assay of serum thyrotropin (TSH), free‐thyroxine (FT4) and free‐triiodiothyronyne (FT3) were performed in all patients, and in 40 healthy subjects enrolled as control group. Thyroid echogenicity was compared with that of the surrounding neck muscles, using the grey‐scale histogram analysis. The echogenicity was expressed in grey‐scales (GWE). results In HT patients, the mean of thyroid echogenicity was lower when compared to the normal thyroid (61·9 ± 8·3 GWE vs. 71·9 ± 3·1 GWE; P = 0·01). In all HT patients the lowest limit of thyroid echo distribution was in the echogenicity range of the surrounding muscle, the overlapping ranging between 3·4% and 95·0% (mean ± SD 48·4 ± 20·9%). The extension of like‐muscle hypoechogenicity into the thyroid gland was significantly correlated with serum TSH values ( r = 0·37; P < 0·001), serum FT4 values ( r = –0·60; P < 0·001), and serum TPOAb values ( r = 0·31; P = 0·004). Nobody was hypothyroid when the hypoechogenicity was less than 38·0%, whereas hypothyrodism occurred in all cases with hypoechogenicity of more than 68·9%. The receiving operating characteristic curve demonstrated that 48·3% was the best cut‐off for identifying hypothyroid patients with sensitivity, specificity and diagnostic accuracy of 88·9%, 86·3% and 87·6%, respectively. conclusions In conclusion, the grey‐scale quantitative analysis has provided a measure of thyroid hypoechogenicity associated with the appearance of hypothyroidism during the course of HT. The results of the present study would encourage the application of the computerized grey‐scale analysis as complementary tool to US evaluation in the patients affected by HT.