桥本有菜英文名作者：腹部医学影像论坛
Hashimoto thyroiditis, also known as lymphocytic thyroiditis or chronic autoimmune thyroiditis, is a subtype of autoimmune thyroiditis. It is one of the most common thyroid disorders.
Radiographic features
【Hashimoto Thyroiditis 桥本甲状腺炎】
桥本甲状腺炎，又叫淋巴细胞性甲状腺炎或慢性自免性甲状腺炎，是自免性甲状腺炎的一种亚型 。是最常见的甲状腺疾病之一 。
Ultrasound
It is difficult to reliably sonographically differentiate Hashimoto thyroiditis from other thyroid pathology. Ultrasound features can be variable depending on the severity and phase of disease :
diffusely enlarged thyroid gland with a heterogeneous echotexture is a common sonographic presentation；
the presence of hypoechoic micronodules (1-6 mm)with surrounding echogenic septations is also considered to have a relatively high positive predictive values .This appearance may be described as pseudonodular or a giraffe pattern;
colour Doppler study usually shows normal or decreased flow, but occasionally there might be hypervascularity similar to a thyroid inferno;
prominent reactive cervical nodes may be present, especially in level VI, but they have normal morphologic features;
patients are at higher risk for papillary thyroid carcinoma, so a discrete nodule should be considered for biopsy;
In some situations, large nodules may be present, which may be referred to as nodular Hashimoto thyroiditis 10.
影像表现：
超声：很难在声像图上鉴别桥本甲状腺炎与其他甲状腺疾病 。超声表现取决于疾病的严重程度与时期 。
-甲状腺弥漫性增大、回声不均质是常见的超声表现 。
-低回声微结节（1-6mm）伴周围回声分隔，也考虑较高的阳性值 。该征象称为“假结节征”或“长颈鹿征” 。
-彩色多普勒超声显示血流信号正常或减低，但有时也会有丰富的血流信号，类似“甲状腺火海征” 。
-主要的表现可能为颈部结节，特别是在6级病变中，但甲状腺形态正常 。
-桥本甲状腺炎的患者有患乳头状甲状腺癌的高风险，因此单发孤立结节应考虑活检 。
某些情况下会表现为大结节，可能会是结节性桥本甲状腺炎 。
【桥本有菜英文名】Nuclear medicine
Radioactive iodine
early stages: may show increased uptake
late stages: single or multiple areas of reduced uptake (cold spots)
核医学
放射性碘
-早期：可表现为高度浓聚
-晚期：单发或多发浓聚减低（冷结节）
Pathology
There is autoimmunity to the thyroid gland which bears both humoral-and cell-mediated features. This is followed by lymphocytic
infiltration of the thyroid gland with lymphoid follicles replacing thyroid follicles. This may affect the thyroid gland in either a diffuse or focal manner. Cell populations include:
lymphocytic aggregates
transformed follicular cells
(Askanazy/oxyphilic/Hurthle cells)
Later stages show superadded fibrosis.
病理表现：甲状腺是自身调节的腺体，受激素水平和细胞介导通路的调节 。由于淋巴细胞的浸润，导致淋巴滤泡取代了正常的甲状腺滤泡 。以弥漫或局灶性的方式侵犯甲状腺 。细胞群包括：
-淋巴细胞聚集 。
-滤泡细胞转运（Askanazy/亲氧/Hurthle细胞） 。
晚期表现为极度的纤维化 。
Notes：
1. Hashimoto thyroiditis [?θa????'da?t?s] n. 桥本甲状腺炎
2. lymphocytic [?l?mf?'sa?t?k] adj. 淋巴细胞的
3. echotexture [e??'tekst??] 回声特性
4. morphologic [?m?:f?'l?d??k] adj. 形态学（上）
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