Ultrasonographic Characteristics and Risk Factors of Hypothyroidism in Subacute Thyroiditis Diagnosed by Different Ultrasonography
Objective:To investigate the ultrasonographic characteristics and risk factors of hypothyroidism in subacute thyroiditis diagnosed by different ultrasonography.Methods:121 patients with subacute thyroiditis who were treated in our hospital from October 2022 to April 2023 were enrolled for the first thyroid ultrasound examination and clinical data were followed up for 6 months.The longi-tudinal and transverse section of the bilateral lobar thyroid gland was examined and recorded by conventional ultrasound mode(2D,Doppler),and then the elastic imaging mode was activated for scanning.The general clinical data of subacute thyroiditis patients with hypothyroidism and those without hypothyroidism were compared,and the early ultrasonographic characteristics of two-dimensional,Doppler and elastic ultrasonography were compared.Univariate analysis and multivariate Logistic regression were used to analyze the risk factors of hypothyroidism in subacute thyroiditis patients.ROC curve was used to analyze the value of elastic modulus,strain rate,superior thyroid artery resistance index and velocity in predicting hypothyroidism in patients with subacute thyroiditis.Results:121 patients with subacute thyroiditis were followed up in 115 cases,of which 29 had hypothyroidism and 86 had no hypothyroidism.The proportion of hypothyroidism was 25.22(29/115).According to statistical analysis,the period of hypothyroidism in subacute thyroiditis patients was related to the peak velocity and resistance index of the superior thyroid artery involved in the lateral lobe and focal area(P＞0.05).The elastic modulus and strain rate of subacute thyroiditis patients with hypothyroidism were significantly higher than those without hypothyroidism(P＞0.05).ROC curves of peak velocity,resistance index,elastic modulus and strain rate of thyroid artery in focal area for hypothyroidism in subacute thyroiditis patients showed that the AUC of elastic modulus was 0.898,the approximate exponent was 0.770,the sensitivity was 82.8％,the specificity was 94.2％,and the cut-off value was 114.5.The strain rate AUC was 0.74,the Jor-den index was 0.422,the sensitivity was 72.4％,the specificity was 69.8％,and the cutoff value was 8.2.The resistance index AUC was 0.76,the Yoden index was 0.562,the sensitivity was 65.5％,the specificity was 90.7％,and the cut-off value was 0.66.The flow velocity AUC of superior thyroid artery was 0.838,the Yoden index was 0.608,the sensitivity was 72.4％,the specificity was 88.4％,and the trun-cation value was 25.94.The results of univariate analysis showed that the comparison of FT3,FT4,TRAb,ESR and hs-CRP between subacute thyroiditis and no thyroiditis showed statistical significance(P＜0.05).The results of Logistic regression analysis indicated that elevated FT4,TRAb,ESR,and hs-CRP were risk factors for hypothyroidism in subacute thyroiditis(P＜0.05).Conclusion:The combination of two-dimensional ultrasound,Doppler ultrasound and elastic ultrasound can predict hypothyroidism early after subacute thyroiditis.The risk factors for hypothyroidism in subacute thyroiditis are levels increased of FT4,TRAb,ESR and hs-CRP.
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