Evaluation of the Stiffness of Thyroid Parenchyma With Shear Wave Elastography Using a Free–Region of Interest Technique in Graves Disease

Abstract

Objectives The first aim was to evaluate the stiffness of thyroid parenchyma with shear wave elastography (SWE) in patients with Graves disease (GD) and compare the elastographic values with those of asymptomatic volunteers. The second aim was to evaluate whether there was a correlation between SWE values and grayscale ultrasound (US) and laboratory parameters. Methods In this prospective study, the thyroid gland parenchyma of 50 patients whose clinical and laboratory findings were indicative for GD and 54 asymptomatic participants with normal laboratory values was examined by SWE. Grayscale US images of the thyroid and submandibular gland were recorded. The volume of the thyroid gland was measured. Elastographic measurements were performed with a free region of interest. The quantitative SWE values (meters per second and kilopascals) of the patient and control groups were compared. A correlation analysis between the SWE values and grayscale US and laboratory parameters was performed. Results The median (range) SWE values of the thyroid gland in patients with GD were significantly higher than those of the control group [17.34 (12.58–56.15) versus 12.05 (7.72–23.67) kPa and 2.28 (1.83–4.12) versus 1.92 (1.55–2.61) m/s; P < .001 for both comparisons]. When 14.5 kPa or 2.115 m/s was designated as the cutoff value, GD could be diagnosed with a high sensitivity and specificity. We showed a negative weak correlation between the SWE values and parenchymal echogenicity in the GD group. Conclusions Shear wave elastography can be used as an effective imaging method with high sensitivity and specificity rates in the diagnosis of GD.

Shear-Wave Elastography in Diffuse Thyroid Diseases

“…A negative correlation was found between SWE values and TSH values. Between fT3, fT4 levels, and SWE values were found a strong positive correlation [50].…”

Association of autoimmune thyroid disease with type 1 diabetes mellitus and its ultrasonic diagnosis and management

“…In addition, a new-generation Doppler designed for improving diagnostic sensitivity, microvascular ultrasonography, has also been tested regarding its ability in the differential diagnosis of GD and HT[ 136 ] or destructive thyroiditis[ 137 ] in a quantitative and real-time manner with low intra- or inter-observer variability. In addition, some tests analyzing the ability of shear-wave elastography in diagnosing GD show that it can be applied as a complementary technique to facilitate the diagnosis of GD[ 138 ] or the differential diagnosis of GD and HT[ 139 ].…”

Diagnostic performance of gray‐scale ultrasound and shear wave elastography in assessing salivary gland involvement in patients with primary Sjögren's syndrome

“…Tissue elasticity is quantified as the elasticity modulus in kilopascals (kPa) or the shear wave velocity in meters per second (m/s) 15,16 . SWE has been proven in studies on the breast, thyroid, and liver to be capable of assessing tissue stiffness 15–20 . There are also US studies in the literature evaluating the elastography properties of the salivary glands in pSS and reporting that it may have a potential role in the detection of parotid lymphoma 11,14,21–29 .…”

“…15,16 SWE has been proven in studies on the breast, thyroid, and liver to be capable of assessing tissue stiffness. [15][16][17][18][19][20] There are also US studies in the literature evaluating the elastography properties of the salivary glands in pSS and reporting that it may have a potential role in the detection of parotid lymphoma. 11,14,[21][22][23][24][25][26][27][28][29] As far as we are aware, no study has examined all clinical data, gray-scale US, and SWE for assessment of salivary glands in pSS.…”