Endocrine Abstracts (2006) 11 P889

Application of MRI in the differential diagnosis of different forms of Hashimoto’s thyroiditis in patients from the iodine deficient region

G Vagapova1 & I Mikhailov2

1Kazan State Medical Academy, Kazan, Russia; 2Interregional Diagnostic Center, Kazan, Russia.

The purpose of this study was to describe MRI signs of Hashimoto’s thyroiditis (HT) in patients from the iodine deficient region.

30 euthyroid patients with HT from the iodine deficient region and 5 healthy individuals were examined by MRI in FSE T1 and T2 pulse sequences. The diagnosis was confirmed according to the standard criteria.

The atrophic form of HT (2 cases) showed the reduction of thyroid volume with denominated lobularity of its structure and prevalence of low signal intensity on T1- and T2-weighted images. The focal form of HT (2 cases) demonstrated blurring sidebars and structure of smitten lobe with slightly hyperintensity on T2- and insignificant hypointensity on T1-mode. The hypertrophic form of HT (26 cases), as well as diffuse (20 cases) and diffuse-nodular (6 cases) variants noted 2 types of changes. The first type showed the increased thyroid volume, blurring and ingomogenity of its structure with hyperintensity on T2 mode (5 cases). The second type was distinguished by presence of multiple hyperintensive spots in T1 and T2 pulse sequences with signs of the first type (11 cases). Obtained diversity of MRI appearances may be explained by existence of several histological forms of HT. Presence of hyperintensive spots on T1- and T2-weighted images can be explained by colloid accumulation in patients with HT, developed on the background of endemic goiter (morphologicaly it was defined as chronic lymphocytic strumitis). All patients (11 persons) with the second type of changes were treated with physiological dozes of iodine. Iodine assumption resulted in reliable reduction of thyroid volume and disappearens of multiple hyperintensive spots in T1 and T2 pulse sequences.

MRI-tomography of thyroid may be useful in differential diagnosis of various forms of HT. Patients with HT defined as chronic lymphocytic strumitis should be treated with physiological doses of iodine.

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