Ultrasound Diagnosis in Diffuse Thyroid Diseases



Diffuse changes confer the diffuse nontoxic goiter (diffuse hyperplasia), diffuse toxic goiter (Graves’ disease), thyroiditis, and some other pathologies. Diffuse nontoxic goiter is characterized by uniform increase in size of the entire gland without any lesions or focal changes of the parenchyma. It is usually a result of severe iodine deficiency. Grayscale US reveals normal structure of thyroid tissue, which looks uniform, homogeneous, and isoechoic. Diffuse toxic goiter (Graves’ disease) leads to excess production of thyroid hormones and thyrotoxicosis. Its most spectacular and important changes can be detected with CDI and PDI. The vascularity of the entire thyroid gland appears significantly increased, often named “thyroid inferno.” In grayscale mode, the ultrasound image of the thyroid parenchyma in Graves’ disease may be similar to certain types of autoimmune thyroiditis. In Hashimoto’s thyroiditis usually the whole gland is affected. The thyroid gland may be enlarged, but often the size is normal. Irregular decrease in echodensity and diffuse heterogeneity of the parenchyma resulting from hypoechoic areas of various sizes distributed within the thyroid tissue is registered along with other ultrasound signs. Subacute (De Quervain’s) and acute thyroiditis are of viral and bacterial origin, respectively, and exhibit specific ultrasound signs.


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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Ultrasound DiagnosticsCenter for Radiological Diagnostics of Non-State Healthcare Institution Yaroslavl Railway Clinic of JSC “Russian Railways”YaroslavlRussia
  2. 2.Department of Visual and Functional Diagnostics of National Research Center for Obstetrics, Gynecology and PerinatologyMinistry of Healthcare of the Russian FederationMoscowRussia
  3. 3.Department for Internal Diseases Propaedeutic, Course of Diagnostic Radiology of Medical Faculty of Federal State Budget Educational Institution of Higher Education “I. N. Ulianov Chuvash State University”CheboksaryRussia
  4. 4.Ultrasound Diagnostics DepartmentMedical Diagnostic CenterMoscowRussia

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