Association Between Thyroid Antibodies and Ultrasonic Imaging in Patients with Hashimoto's Thyroiditis

Aim: The association between high levels of anti-thyroid antibodies and the extent of destruction of thyroid tissue is well documented. The aim of the present study was to analyze the relationship between anti-thyroid antibodies, thyroid hormones, and sonographic parenchymal changes. Methods: The study was designed as a case-control study. Four hundred and seventy-five patients with HT and 98 healthy subjects were included in the study. Serum levels of free thyroxine (fT4), free triiodothyronine (fT3), thyroid-stimulating hormone, and anti-thyroid antibodies (anti-thyroid peroxidase antibodies and anti-thyroglobulin antibodies) were measured. The ultrasonographic results of the patients were also recorded. Results: Serum levels of anti-TPO and anti-Tg were significantly associated with hypoechogenicity, heterogeneity, and pseudonodulation (p<0.001). There was no significant difference between the two groups in terms of cyst and nodule formation, however, a significant difference was found in terms of thyroid volume (p<0.001). Thyroid volumes were higher in the HT group. As serum anti-TPO levels increased in the HT group, parenchymal hypoechogenicity increased (p<0.001). Conclusion: Ultrasonography is a non-invasive method that provides information about the inflammatory activity of the thyroid gland. Significantly reduced echogenicity, heterogeneity, and multifocal pseudonodular infiltration were indicators of inflammatory activity and were associated with higher anti-TPO levels. Anti-TPO and ultrasonographical changes may be useful in the follow-up of Hashimoto's thyroiditis.