Analysis of Ultrasonic Characteristics of Hashimoto's Thyroiditis Benign Nodules and Its Relationship with Serum TSH

Objective: Discuss the relationship between ultrasonic characteristics of Hashimoto's thyroiditis benign nodules (HTBN) and serum TSH. Methods: We summarized 117 cases who were diagnosed as HTBN by thyroid fine needle aspiration according to the inclusion criteria from January 2012 to December 2013 in our department. 32 cases were misdiagnosed by ultrasound as malignant nodules. Using a random number table, we selected 32 patients whose diagnosis was correct as the control group according to 1:1 principle. Comparison between these two groups and the relationship with serum TSH were analyzed. Results: The ultrasound misdiagnosis group, serum TSH value was (6.32 ± 1.11) uIU/ml, while the ultrasound diagnosis group was (2.08 ± 1.23) uIU/ml, P value was 0.047. With the increase of serum TSH concentration, the proportion of HTBN ultrasound misdiagnosis increased gradually (P=0.002). In ultrasound misdiagnosis group, low echo, irregular shape, irregular boundary, inhomogeneous echo and aspect ratio more than 1 were higher than ultrasound diagnosis group. P values were 0.000, 0.000, 0.000, 0.026 and 0.011. In ultrasound misdiagnosis group, for nodular echo, shape and boundary characteristics, serum TSH value was higher than the ultrasound diagnosis group, P values were 0.037, 0.026 and 0.021. Conclusion: Under Hashimoto's thyroiditis (HT) background, ultrasound characteristics of benign nodules are of great uncertainty. Especially for patients with elevated serum TSH, ultrasound characteristics in nodular echo, shape, boundary does not have great reference value. Differential diagnosis of benign and malignant nodules in Hashimoto's thyroiditis should be made according to the patient's condition, using various individual diagnostic techniques. In this way, we can improve the accuracy of diagnosis and reduce the clinical misdiagnosis and mistreatment.