Objective:To analyze the image characteristics of Hashimoto's thyroiditis (HT),study the correlation between thyroid images and thyroid function,thyroid autoantibodies (TPOAb,TGAb) titer.To explore the value of 18F-FDG metabolism imaging in the management of HT.Methods:Patients underwent 18F-FDG SPECT/CT metabolic imaging from May 2013 to March 2023 were retrospectively analyzed.The patients with HT were screened.The characteristics of thyroid imaging on 18F-FDG metabolism imaging were analyzed by visual and semi-quantitative analysis.According to visual observation,the uptake of 18F-FDG by the thyroid is divided into levels 0 to 4,namely non thyroid uptake,thyroid uptake below the liver,equal to the liver,higher than the liver,and significantly higher than the liver.The semi-quantitative analysis method was to calculate the ratio of thyroid to liver radioactivity uptake (T/L).The correlation between thyroid imaging and thyroid function were ana-lyzed by Linear correlation analysis,t test,rank sum test and other statistical methods.Results:Twenty-four patients with HT were enrolled in this study,including 4 males and 20 females,aged (63.50±12.93) years,with 10 hypothyroidism,11 euthy-roidism and 3 hyperthyroidism.Two of the 24 patients were complicated with papillary thyroid carcinoma with multiple cervi-cal lymph node metastasis,in the remaining 22 HT patients,except for 1 case with focal radioactivity accumulation in one lobe of the thyroid,the other 21 cases showed diffuse imaging in both lobes of the thyroid.There was a weak positive corre-lation between T/L and TSH level(r=0.411,P<0.05).The T/L values in hypothyroidism group was higher than that in euthyroid group(t=-3.535,P<0.05).Hierarchical analysis was performed according to TPOAb and TGAb titers,and T/L values had statis-tically significant difference in TPOAb titers among<300 kU/L,300～<600 kU/L,and ≥600 kU/L groups(H=9.788,P<0.05).The T/L values in the TPOAb≥600 kU/L group was higher than those in<300 kU/L groups (Bonferroni correction P<0.05) .TGAb titer<200 kU/L,200～<500 kU/L and ≥500 kU/L had statistically significant differences in T/L values (H=8.223,P<0.05).The T/L values in TGAb<200 kU/L group was lower than those in 200～<500 kU/L group (Bonferroni correction P<0.05).The T/L values in the other two groups of TPOAb and TGAb had no statistically significant difference (Bonferroni correction P>0.05).Conclusion:HT and hypothyroidism should be excluded when diffuse thyroid uptake on 18F-FDG metabolism imaging.18F-FDG metabolism imaging has certain clinical value in the management of the mid-advanced stage HT and HT complicated with thyroid cancer.
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