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声辐射力脉冲定量技术在桥本甲状腺炎患儿甲状腺弹性评估中的应用

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

作者信息

Yucel Serap, Ceyhan Bilgici Meltem, Kara Cengiz, Can Yilmaz Gulay, Aydin H Murat, Elmali Muzaffer, Tomak Leman, Saglam Dilek

机构信息

Departments of Radiology, Ondokuz Mayis University School of Medicine, Samsun, Turkey.

Departments of Pediatric Endocrinology, Ondokuz Mayis University School of Medicine, Samsun, Turkey.

出版信息

J Ultrasound Med. 2018 May;37(5):1143-1149. doi: 10.1002/jum.14459. Epub 2017 Oct 24.

DOI:10.1002/jum.14459
PMID:29064111
Abstract

OBJECTIVES

To evaluate the parenchymal elasticity of the thyroid gland with acoustic radiation force impulse imaging in pediatric patients with Hashimoto thyroiditis and to compare it with healthy volunteers.

METHODS

Twenty-six patients with Hashimoto thyroiditis and 26 healthy volunteers between 6 and 17 years were included. The shear wave velocity (SWV) values of both thyroid lobes in both groups were evaluated.

RESULTS

The age and sex characteristics of the controls and patients with Hashimoto thyroiditis were similar. The SWV of the thyroid gland in patients with Hashimoto thyroiditis (mean ± SD, 1.67 ± 0.63 m/s) was significantly higher than that in the control group (1.30 ± 0.13 m/s; P < .001). There was no significant difference between the thyroid lobes in both groups. A receiver operating characteristic curve analyses showed an optimal cutoff value of 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). In patients with Hashimoto thyroiditis, there was a positive correlation between the SWV values versus anti-thyroperoxidase (Pearson r = 0.46; P = .038). There were no correlations between age, body mass index, thyroid function test results, and anti-thyroglobulin values and versus SWV values. Also, no significant differences were seen between the groups for gland size, gland vascularity, and l-thyroxine treatment.

CONCLUSIONS

Acoustic radiation force impulse elastography showed a significant difference in the stiffness of the thyroid gland between children with Hashimoto thyroiditis and the healthy group. Using acoustic radiation force impulse elastography immediately after a standard ultrasound evaluation may predict chronic autoimmune thyroiditis.

摘要

目的

采用声辐射力脉冲成像技术评估桥本甲状腺炎患儿甲状腺实质弹性,并与健康志愿者进行比较。

方法

纳入26例6至17岁的桥本甲状腺炎患者和26名健康志愿者。评估两组双侧甲状腺叶的剪切波速度(SWV)值。

结果

对照组和桥本甲状腺炎患者的年龄和性别特征相似。桥本甲状腺炎患者甲状腺的SWV(均值±标准差,1.67±0.63 m/s)显著高于对照组(1.30±0.13 m/s;P <.001)。两组甲状腺叶之间无显著差异。受试者工作特征曲线分析显示,最佳截断值为1.41 m/s,灵敏度为73.1%,特异度为80.8%,阳性预测值为79.2%,阴性预测值为75.0%(曲线下面积,0.806;P <.001)。在桥本甲状腺炎患者中,SWV值与抗甲状腺过氧化物酶呈正相关(Pearson r = 0.46;P =.038)。年龄、体重指数、甲状腺功能检查结果、抗甲状腺球蛋白值与SWV值之间无相关性。此外,两组在腺体大小、腺体血管和左甲状腺素治疗方面无显著差异。

结论

声辐射力脉冲弹性成像显示,桥本甲状腺炎患儿与健康组甲状腺硬度存在显著差异。在标准超声评估后立即使用声辐射力脉冲弹性成像可能预测慢性自身免疫性甲状腺炎。

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