橋本甲狀腺炎課件

TheultrasonicdiagnosisofHashimotothyroiditisTutor:ZhengMinSpeaker:WangLingIntroductionClinicalmanifestationsUltrasoundperformanceDifferentialdiagnosisSummary

Hashimotothyroiditisalsocalledchroniclymphocyticthyroiditis,JapanesescholarsHashimotoreportedfirstly

accordingtothehistologicfeatures，thatisthemostcommononeofautoimmunethyroiddiseases.HTdiseaseslowly,clinicalmanifestationisnotverytypical;Andthecourseofalong,pathologicalchangesandthyroidfunctionstateperformanceisdifferent,sotheultrasonographyfindingsiscomplex.IntroductionUltrasonographiccharacteristicsthyroiddiffuseenlargementofasymmetry,

isthmus

is

obvious.Theinternalechoreduction,unevendistribution.Thevisiblethinwire-likeorcoarsenetwork-like

strong

echo.

TwodimensionalultrasonographyLocalHTisrelativelyrare,thatisaspecialtype,earlymanifest.Suchaseffectivelyandtimelytreatment,prognosisandoutcomeisbetterUltrasonographyisonesideorbothsidelobeofthyroidownsingleormultipleunevenandhypoechoiczone,boundaryclear,formowerules,like“pattern”,spaceoccupyinglesioneffectisnotobvious.EchoUnevennesstype:Normalthyroidvolumeorbiger,multipleuneven,Increasingcoarseorfinewiresamplestrongecho.Patchtype:Normalthyroidvolumeorbiger,diffuseddistributionsheethypoecho.Diffusetype:Thyroidvolumeincrease,Essenceisdiffusetypeechoreduce.Nodulestype:Thyroidvolumeincrease,diffusedistributionrangingfromthesizeofthehigh、loworequalecho.Classification回聲不均型：甲狀腺球蛋白抗體（TGA）陽(yáng)性，T3、T4、TSH正常斑片型結(jié)節(jié)型

Ultrasonicfoundtrachealsideswollenlymphnodes,Isautoimmunethyroiddiseasemorespecificultrasoniconeofthesigns,manifest:Thyroidisthmusfront,bilateralleafunderroundorovalechoic,morphologicalrules,partoftheskinmedullaboundaryclear.

earlyperiod:essenceBloodflowsignalrich,Eventheinfernosign,PSVrise,Prompthyperthyroidismornormal.Withtheprogressofthedisease:Therichbloodflowsignificantlylowerlevel,PSVdroppedevenlowerthannormal,Prompttypothyroidism.laterperiod:Bloodflowsignalsignificantlyreduced,velocityobviouslyreduced,PromptThyroidfunctionsignificantlyimpaired.CDFISubacutethyroiditisNodulargoiterHyperthyroidismDifferentialdiagnosis

Thyroidprofileisnormalorincreased，seeninsheethypoechoicarea，moreirregular，rearechoslightlyenhanced，theisthmusisnoobviousthickening。

CDFI：bloodflowisrichsurroundinghypoechoicarea，butinternalflowsignalsisfewerornoSignal。

Subacutethyroiditis

Theformerincrease

mainly

aboutthesizeofthyroid，thelatterincrease

mainlyanteroposteriordiameter，Isthmusthickening，aninternalnetworkoracord-likeechogenic。Hyperthyroidism甲亢

Twodimensionalultrasonography：Thyroidsolitaryormultiplenodules，Varyinsize、Echodiversifi