Chronic lymphocytic thyroiditis - Figure 9. Change in the ultrasound pattern.

Except for post partum thyroiditis, the echo pattern of the thyroid changes very slowly over decades. Not only nodules but discrete hypoechogenic areas remain unchanged. On the other hand, an enlarged thyroid will become significantly smaller as the TSH level decreases.

It is worth comparing the stable echo pattern of the thyroid in the example demonstrated below. Although the size of the thyroid and the initially increased vascularization decreased significantly over 18 months, the location of more hypoechogenic areas and fibrotic bundles remained unchanged. Compare the images in the second row.