Department of Radiology, Medicine Faculty, Sutçu Imam University, Kahramanmaraş, Türkiye.
Department of Radiology, Konya Training and Research Hospital, Health Sciences University, Konya, Turkey.
J Ultrasound. 2020 Dec;23(4):543-551. doi: 10.1007/s40477-020-00437-y. Epub 2020 Mar 17.
We aimed to investigate the use and effectiveness of Shear-Wave Elastography (SWE) in Hashimoto's Thyroiditis (HT) diagnosis and compare the SWE values in HT patients with asymptomatic volunteers.
The thyroid gland parenchyma of 74 patients whose clinical and laboratory findings and ultrasonography (US) features were indicative of HT and 75 healthy, asymptomatic participants with normal laboratory values were examined using SWE. Their thyroid parenchymal echoes and thyroid gland volume were measured using B-mode US examination. Elastographic measurements were made by plotting the boundaries of thyroid gland by hand, using Free Region of Interest (ROI). The quantitative SWE values [meters/second (m/s) and kilopascal (kPa)] were compared betweent the patients and the controls. The correlation analyses between the SWE measurements and the autoantibodies [Anti-thyroid peroxidase antibody (TPOAbs) and anti-thyroglobulin antibodies (TgAbs)], thyroid-stimulating hormone (TSH), freetriiodothyronine (fT3), free-thyroxine (fT4), and thyroglobulin levels were performed.
The mean thyroid SWE measurement values of HT group were significantly higher than the asymptomatic group (p < 0.001). This study proposes 29.45 kPa or 2.77 m/s as a sensitive-spesific cut-off value for HT. We revealed significant positive association between SWE values and TgAb levels, gland volume, TgAb, TPOAb levels, and a significant negative association between SWE and echogenicity (p < 0.001).
In the assessment of HT, SWE is a highly sensitive imaging method to estimate the degree of fibrosis and to provide objective numerical values.
本研究旨在探讨剪切波弹性成像（SWE）在桥本甲状腺炎（HT）诊断中的应用及效能，并比较 HT 患者与无症状志愿者的 SWE 值。
对 74 例临床和实验室检查及超声（US）表现符合 HT 且实验室检查正常的无症状志愿者的甲状腺实质进行 SWE 检查，同时对 75 例临床和实验室检查及 US 表现符合 HT 的患者的甲状腺实质进行 SWE 检查。采用 B 型 US 检查测量甲状腺实质回声和甲状腺体积。采用手动绘制甲状腺边界的自由 ROI 进行弹性测量，比较患者与对照组之间的 SWE 定量值（米/秒[m/s]和千帕斯卡[kPa]）。分析 SWE 测量值与抗甲状腺过氧化物酶抗体（TPOAb）、抗甲状腺球蛋白抗体（TgAb）、促甲状腺激素（TSH）、游离三碘甲状腺原氨酸（fT3）、游离甲状腺素（fT4）和甲状腺球蛋白水平之间的相关性。
HT 组的甲状腺 SWE 平均值明显高于无症状组（p<0.001）。本研究提出 29.45 kPa 或 2.77 m/s 作为 HT 的敏感特异性截断值。我们发现 SWE 值与 TgAb 水平、腺体体积、TgAb、TPOAb 水平呈显著正相关，与回声强度呈显著负相关（p<0.001）。
在评估 HT 时，SWE 是一种高度敏感的成像方法，可评估纤维化程度并提供客观的数值。
