# Comparison of Thyroid Gland Sonography Index with Serum Antithyroid Peroxidase, Antithyroglobulin, and Thyroid Function Tests in Patients with Hashimoto Thyroiditis

## TL;DR

This study compares thyroid ultrasound features with blood tests in Hashimoto's thyroiditis patients to understand disease severity.

## Contribution

The study identifies correlations between ultrasound findings and antibody levels in Hashimoto's thyroiditis patients.

## Key findings

- Macro-nodules correlate with higher TSH, anti-Tg, and anti-TPO antibody levels.
- Thicker thyroid isthmus correlates negatively with FT3 and FT4 levels.
- Ultrasound features may reflect disease severity in Hashimoto's thyroiditis.

## Abstract

Background: Ultrasound examination of the thyroid has emerged as a useful
diagnostic and prognostic tool, along with measuring serum titers of
anti-thyroid peroxidase (TPO), anti-thyroglobulin (Tg), and thyroid hormones, in
patients with Hashimoto's thyroiditis. So, we aimed at considering correlations
of ultrasonographic, antibodies, and thyroid hormone levels. Materials and
Methods: A total of 149 patients (118 females, 31 males; aged 18–60 years; mean
age: 38.60 ± 8.03 years) who were diagnosed with Hashimoto's thyroiditis were
enrolled in the study. The blood sample was taken to measure serum titers of
free T3 (FT3) and T4 (FT4), TSH, anti-TPO, and anti-Tg antibody titers. The
thyroid sonography of each patient was classified into one of the five grades by
real-time ultrasound (US) based on echogenicity, thyroid size, and thyroid
pattern. We evaluated whether there was a correlation between thyroid
characteristics observed via ultrasound and serum levels of thyroid hormones,
anti-TPO antibodies, and anti-Tg antibodies. Results: Nodular structures were
detected in 54 (36.2%) patients (38 micro-nodular and 16 macro-nodular).
Echogenicity was recorded as isoechoic in 15(10.07%) and hypoechoic in 119
(79.87%) subjects. Euthyroid subjects had significantly thicker isthmus than
overt and subclinical hypothyroid patients (P=0.018). Mean serum TSH, anti-Tg,
and anti-TPO antibody titers showed a significant increase in patients with
macro-nodules compared to those with micro-nodules and individuals without
nodules (P0.05). The thickness of the isthmus had a significant negative
correlation with FT4 (P=0.046; r=0.11) and FT3 (P=0.017; r=0.15), respectively.
Thyroid autoantibodies had positive significant correlations with different
parameters of thyroid volume (P0.05). Conclusions: Thyroid US findings, in
addition to serum anti-Tg and anti-TPO antibody titers, might be correlated with
the severity and extent of Hashimoto's thyroiditis, but further evaluations are
needed.