[Echography and cytologic exam by needle aspirate in the diagnosis of chronic thyroiditis].
OBJECTIVE
In this study the diagnostic accuracy and clinical, usefulness of sonography and fine needle aspiration (FNA) cytology in the diagnosis of chronic autoimmune thyroiditis (CAT) was evaluated.


METHODS
An analysis on 220 patients showing elevated serum titers of anti-thyroperoxidase and/or anti-thyroglobulin antibodies and laboratory features of hypothyroidism.


RESULTS
According to thyroid sonographic character CAT patients were classified into four groups. Group I included patients with an enlarged and diffusely hypoechogenic thyroid gland. Group II comprised patients with a sonographic pattern of multiple focal hypoechogenicities. In group III patients showed a hypoechogenic thyroid gland with single or multiple nodules and scattered hyperechogenic areas. Group IV included patients with a isoechogenic and small thyroid gland characterized by the presence of numerous hyperechogenic spots and strings.


CONCLUSIONS
The most frequent sonographic pattern (72%) associated with CAT was observed in group III patients with a plurinodular and hypoechogenic thyroid. Sonographic patterns observed in group I and II patients are instead highly specific for CAT, since all cases were confirmed at cytology. The high prevalence of cytologic inadequate specimens in group III and IV patients may be related to the higher fibrotic content of their thyroids (multiple hyperechogenicities).


CONCLUSIONS
Sonography may represent a useful tool in the diagnostic evaluation of CAT. Information provided by this technique is always to be considered as complementary to that offered by other conventional methods, such as FNA cytology and serum antithyroid antibody measurement.
Messina
G
G
Sezione Autonoma di Ecotomografia diagnostica ed interventistica e Color Doppler, Ospedale Madre Giuseppina Vannini, Roma. g.messina@blunet.it
D000328:Adult; D001707:Biopsy, Needle; D002908:Chronic Disease; D003581:Cytodiagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D013961:Thyroid Gland / Q000000981:diagnostic imaging* / Q000473:pathology*; D013967:Thyroiditis, Autoimmune / Q000175:diagnosis*; D018615:Ultrasonography, Doppler, Color
Ecografia ed esame citologico mediante agoaspirato nella diagnosi di tiroidite cronica.