Unit of Internal Medicine and Endocrinology, Fondazione Salvatore Maugeri I.R.C.C.S., University of Pavia, Italy.
Clin Endocrinol (Oxf). 2012 Jan;76(1):137-41. doi: 10.1111/j.1365-2265.2011.04170.x.
ShearWave™ Elastography (SWE) is real-time, quantitative and user-independent technique, recently introduced in the diagnostic work-up of thyroid nodules. Hashimoto's thyroiditis (HT), characterized by variable degrees of lymphocytic infiltration and fibrosis, might affect shear wave propagation. The aim of this study was to assess the feasibility of SWE in cytologically benign thyroid nodules within both Hashimoto's and nonautoimmune thyroid glands. The effect of autoimmunity on the gland stiffness was also evaluated.
longitudinal study in a single centre.
SWE was performed in 75 patients with a benign thyroid nodule at cytology: 33 with Hashimoto's thyroiditis (HT group) and 42 with uni- or multi-nodular goitre, negative for thyroid autoimmunity (non-HT group).
The elasticity index (EI) of the extra-nodular tissue was greater, though not statistically significant, in the HT than in the non-HT group (24·0 ± 10·5 kPa vs 20·8 ± 10·4 kPa; P = 0·206). However, the EI of extra-nodular tissue was related to the TPOAb titre in the HT group (P = 0·02) and was significantly higher in patients with HT receiving L-thyroxine than in the euthyroid subjects (P = 0·02). The EI of thyroid nodules was similar in HT and non-HT groups. In both groups, the stiffness of nodules was significantly higher than that of the embedding tissue.
Our data indicate that SWE correctly defines the elasticity of thyroid nodules independently from the coexistence of autoimmune thyroiditis, always being able to differentiate nodular tissue from the surrounding parenchyma. In HT, the stiffness of extra-nodular tissue increases in relation to both the thyroid antibody titre and the degree of impairment of thyroid function.
剪切波弹性成像（SWE）是一种实时、定量且用户独立的技术，最近被引入甲状腺结节的诊断工作中。桥本甲状腺炎（HT）的特征是淋巴细胞浸润和纤维化程度不同，可能会影响剪切波的传播。本研究旨在评估 SWE 在甲状腺细胞学良性结节中的可行性，包括桥本氏甲状腺炎和非自身免疫性甲状腺中的结节。还评估了自身免疫对腺体硬度的影响。
单中心纵向研究。
对 75 例甲状腺细胞学良性结节患者进行了 SWE 检查：33 例为桥本氏甲状腺炎（HT 组），42 例为甲状腺自身免疫阴性的单发或多发结节性甲状腺肿（非-HT 组）。
HT 组的甲状腺外组织弹性指数（EI）虽无统计学意义但较高（24.0 ± 10.5 kPa 比 20.8 ± 10.4 kPa；P = 0.206）。然而，HT 组甲状腺外组织的 EI 与 TPOAb 滴度相关（P = 0.02），且 HT 组接受 L-甲状腺素治疗的患者高于甲状腺功能正常的患者（P = 0.02）。HT 组和非-HT 组的甲状腺结节 EI 相似。在两组中，结节的硬度均明显高于周围组织。
我们的数据表明，SWE 能够正确定义甲状腺结节的弹性，独立于自身免疫性甲状腺炎的存在，始终能够将结节组织与周围实质区分开来。在 HT 中，甲状腺外组织的硬度随着甲状腺抗体滴度和甲状腺功能损害程度的增加而增加。
