Hashimoto thyroiditis is a chronic autoimmune disorder that affects the thyroid gland. It occurs when the immune system mistakenly attacks the thyroid, leading to inflammation and damage.

This condition primarily affects women, and it is most commonly diagnosed between the ages of 30 and 50.

1. Thyroid Ultrasound

A thyroid ultrasound is a non-invasive imaging technique that uses high-frequency sound waves to produce detailed images of the thyroid gland. In cases of Hashimoto thyroiditis, ultrasound findings may show:.

Enlargement of the thyroid gland (diffuse goiter)
Heterogeneous echogenicity (uneven texture)
Irregular borders
Multiple small nodules
Increased vascularity (hypervascularity)

2. Color Doppler Ultrasound

Color Doppler ultrasound is a variation of traditional ultrasound that allows assessment of blood flow within the thyroid gland.

In Hashimoto thyroiditis, color Doppler ultrasound may reveal increased blood flow, indicating inflammation and increased vascularity.

3. Thyroid Scintigraphy

Thyroid scintigraphy, also known as a thyroid scan, involves the injection of a small amount of radioactive material into the bloodstream. A special camera then detects the radioactive particles, producing images of the thyroid gland.

In Hashimoto thyroiditis, the scan typically shows decreased uptake of the radioactive material, indicating reduced thyroid function.

4. Magnetic Resonance Imaging (MRI)

MRI uses a strong magnetic field and radio waves to create detailed cross-sectional images of the body. In Hashimoto thyroiditis, MRI may reveal:.

Thyroid gland enlargement
Increased signal intensity on T2-weighted images, indicating inflammation
Presence of lymph nodes in the neck region

5. Computed Tomography (CT)

Computed tomography, also known as a CT scan, combines a series of X-ray images taken from different angles to create cross-sectional images of the body.

While not as commonly used for diagnosing Hashimoto thyroiditis, CT scans may be performed in certain cases to evaluate the extent of thyroid gland enlargement and assess adjacent structures.

6. Fine-Needle Aspiration (FNA) Biopsy

FNA biopsy involves taking a sample of cells from the thyroid gland using a thin needle. These cells are then examined under a microscope to detect any abnormalities.

While not an imaging technique, FNA biopsy is often used to confirm the diagnosis of Hashimoto thyroiditis if imaging findings suggest inflammation and autoimmune activity.

7. Nuclear Medicine Imaging

In some cases, nuclear medicine imaging techniques such as positron emission tomography (PET) or single photon emission computed tomography (SPECT) may be used to evaluate thyroid gland function and detect any abnormalities associated with Hashimoto thyroiditis.

8. Contrast-Enhanced Ultrasound (CEUS)

CEUS is a specialized ultrasound technique that involves the injection of a contrast agent into the bloodstream to enhance visualization of blood vessels and tissue perfusion.

It may be used in select cases of Hashimoto thyroiditis to assess vascularity and inflammation.

9. Radiographic Contrast Studies

Radiographic contrast studies, such as a barium swallow or an upper gastrointestinal series, are rarely used to evaluate Hashimoto thyroiditis.

However, in some cases, these studies may be performed to assess the relationship between an enlarged thyroid gland and the nearby structures, such as the esophagus and trachea.

10. Summary

Imaging plays a crucial role in the diagnosis and management of Hashimoto thyroiditis.

Various imaging techniques, including thyroid ultrasound, color Doppler ultrasound, thyroid scintigraphy, MRI, CT, FNA biopsy, nuclear medicine imaging, CEUS, and radiographic contrast studies, provide valuable information about the size, texture, vascularity, and overall function of the thyroid gland.

It is important to note that while imaging findings can strongly suggest the presence of Hashimoto thyroiditis, a definitive diagnosis is usually confirmed through a combination of clinical evaluation, laboratory tests (such as thyroid function tests and antibody measurements), and imaging results.