Department of Radiology, VKV American Hospital, İstanbul, Türkiye
Department of Endocrinology, VKV American Hospital, İstanbul, Türkiye
Turk J Med Sci. 2021 Apr 30;51(2):778-786. doi: 10.3906/sag-2008-210.
BACKGROUND/AIM: Hashimoto thyroiditis (HT) is an autoimmune disease that leads to tissue stiffening secondary to lymphocyte infiltration of the thyroid gland. Gray-scale ultrasound (US) is widely used in its diagnosis. Numerous studies have been conducted comparing elastography findings of HT with tissue stiffness and immunoreactivity levels. This study aims to reveal the relationship between shear wave elastography (SWE) and Doppler parameters in patients with HT.
The study group consisted of 45 patients diagnosed with HT, and 20 control patients without thyroid pathology. Thyroid-stimulating hormone (TSH) and antithyroid peroxidase (TPO) values were examined in patients with HT. Thyroid gland volume and echo patterns were evaluated in the gray-scale US. Doppler measurements –peak systolic velocity (Vmax), end-diastolic velocity (Vmin), pulsatility index (PI), resistivity index (RI)– from the superior thyroidal artery and SWE measurements were taken from both thyroid lobes.
The mean age of men and women in the HT group was 44.8 and 43.4 years. The mean TSH value (normal value: 0.3–4.2 uIU/ mL) was 3.90 ± 6.6 uIU/mL, and the anti-TPO value (normal value: < 35 IU/mL) was 235.47 ± 271.12 IU/mL. The average thyroid gland volume was 10.12 ± 2.71 mL in the HT group and 6.62 ± 2.11 mL in the control group (P = 0.034). HT group mean Vmax, mean Vmin, mean PI and RI values were significantly lower compared to normal subjects (P = 0.022, P = 0.026, P = 0.042, P = 0.046, respectively). The average SWE value of the thyroid gland was 24.56 ± 18.04 kPa in the experimental group and 7.34 ± 3.54 (P < 0.05) in the control group.
A positive correlation was found between PI and RI values and elastography values. An increase in SWE and decreases in Vmax and Vmin were found as high diagnostic value for HT.
背景/目的:桥本甲状腺炎(HT)是一种自身免疫性疾病,可导致甲状腺组织因淋巴细胞浸润而变硬。灰阶超声(US)广泛用于其诊断。许多研究比较了 HT 的弹性成像发现与组织硬度和免疫反应水平。本研究旨在揭示 HT 患者的剪切波弹性成像(SWE)与多普勒参数之间的关系。
研究组由 45 名诊断为 HT 的患者和 20 名无甲状腺病理的对照组患者组成。检查 HT 患者的促甲状腺激素(TSH)和抗甲状腺过氧化物酶(TPO)值。在灰阶 US 中评估甲状腺体积和回声模式。从甲状腺上动脉测量多普勒测量值-收缩期峰值速度(Vmax)、舒张末期速度(Vmin)、搏动指数(PI)、阻力指数(RI)-并从甲状腺两叶获取 SWE 测量值。
HT 组男女的平均年龄分别为 44.8 岁和 43.4 岁。平均 TSH 值(正常值:0.3-4.2 uIU/ml)为 3.90 ± 6.6 uIU/ml,抗 TPO 值(正常值:<35 IU/ml)为 235.47 ± 271.12 IU/ml。HT 组的平均甲状腺体积为 10.12 ± 2.71 ml,对照组为 6.62 ± 2.11 ml(P = 0.034)。HT 组的平均 Vmax、平均 Vmin、平均 PI 和 RI 值与正常组相比显著降低(P = 0.022、P = 0.026、P = 0.042、P = 0.046)。实验组甲状腺的平均 SWE 值为 24.56 ± 18.04 kPa,对照组为 7.34 ± 3.54(P < 0.05)。
PI 和 RI 值与弹性成像值呈正相关。SWE 增加以及 Vmax 和 Vmin 降低被认为是 HT 的高诊断价值。