Utility of Shear Wave Elastography for Diagnosing Chronic Autoimmune Thyroiditis

Abstract

The aims of this study were to evaluate the utility of shear wave elastography (SWE) using acoustic radiation force impulse (ARFI) for diagnosing chronic autoimmune thyroiditis (CAT) and to verify the effect of fibrotic thyroid tissue on shear wave velocity (SWV). The subjects were 229 patients with 253 normal thyroid lobes (controls) and 150 CAT lobes. The SWV for CAT (2.47 ± 0.57 m/s) was significantly higher than that for controls (1.59 ± 0.41 m/s) (P < 0.001). The area under the receiver operating characteristics (ROC) curve for CAT was 0.899, and the SWV cut-off value was 1.96 m/s. The sensitivity, specificity, and diagnostic accuracy were 87.4%, 78.7%, and 85.1%, respectively. Levels of anti-thyroperoxidase antibodies and thyroid isthmus thickness were correlated with tissue stiffness in CAT. However, there was no correlation between levels of anti-thyroglobulin antibodies and tissue stiffness. Quantitative SWE is useful for diagnosing CAT, and it is possible that SWE can be used to evaluate the degree of fibrosis in patients with CAT.

Acoustic Radiation Force Impulse Quantification in the Evaluation of Thyroid Elasticity in Pediatric Patients With Hashimoto Thyroiditis

“…In the studies evaluating adults with Hashimoto thyroiditis, the optimal cutoff value of the SWV for differentiating patients with Hashimoto thyroiditis from controls ranged between 1.96 and 2.42 m/s, with various sensitivity and specificity values . The optimal cutoff value in this study was 1.41 m/s, with 73.1% sensitivity, 80.8% specificity, a 79.2 % positive predictive value, and a 75.0% negative predictive value (area under the curve, 0.806; P < .001).…”

“…Similarly, Hekimoglu et al found that patients with Hashimoto thyroiditis had significantly higher SWV values (2.56 ± 0.30 m/s) compared to healthy controls (1.63 ± 0.12 m/s). Fukuhara et al also found the mean SWV of the thyroid gland in patents with Hashimoto thyroiditis to be 2.56 ± 0.29 m/s, and the value in healthy controls was 1.59 ± 0.41 m/s. The results of this study, with a higher mean SWV in the thyroid gland of patients with Hashimoto thyroiditis, are consistent with these studies.…”

“…To the best of our knowledge, there are no studies in the literature about the use of ARFI in pediatric patients with Hashimoto thyroiditis. There were only a limited number of studies in adults, and only a few of these were performed with ARFI elastography . In a study by Sporea et al, the mean SWV of the thyroid gland in patients with Hashimoto thyroiditis (2.43 ± 0.58 m/s) was found to be significantly higher than that in healthy participants (2.00 ± 0.40 m/s).…”

“…Hashimoto thyroiditis is an autoimmune disease caused by lymphocyte infiltration and fibrosis of thyroid parenchyma, resulting in hypothyroidism. The fibrotic changes account for the high SWV values in Hashimoto thyroiditis …”

Thyroid Ultrasound: State of the Art Part 1 – Thyroid Ultrasound reporting and Diffuse Thyroid Diseases

“…However, there was no correlation between levels of anti-thyroglobulin antibodies and tissue stiffness. Quantitative SWE is useful for diagnosing CAT, and it is possible that SWE can be used to evaluate the degree of fibrosis in patients with CAT [50].…”