Factors Affecting Thyroid Elastography in Healthy Children and Patients with Hashimoto’s Thyroiditis

Abstract

Objective: Hashimoto’s thyroiditis (HT) is the most common form of thyroiditis in childhood. In addition to thyroid ultrasonography, shear-wave elastography (SWE) can evaluate thyroid parenchyma tissue stiffness, and more detailed findings can be obtained with this method. We aimed to evaluate the relationship between SWE values and clinical, biochemical and hormonal parameters of patients with HT and in healthy individuals. Methods: We compared 46 newly diagnosed HT cases with 46 healthy controls. We examined the effect of all metabolic parameters and thyroid-related markers on SWE values. Results: The mean SWE values in those patients with euthyroid HT were 12.5±5.1 kilopascal (kPa), whereas it was 8.2±2.82 kPa in healthy controls (p<0.001). Although the clinical [age, gender and body mass index (BMI)] and laboratory parameters (such as thyroid function tests, homeostasis model assessment of insulin resistance, insulin-like growth factor-1 values, which we think may affect SWE scores) of those children with HT and the healthy controls were statistically similar (p>0.05), except for their thyroid autoantibodies and thyroglobulin, SWE values and thyroid volume were significantly higher in those individuals with HT (p<0.001). Multiple linear regression analysis was performed to evaluate the direction and degree of the effect of the variables on thyroid elasticity scores. It was observed that age (p=0.002), BMI standard deviation score (SDS) (p=0.04) and anti-thyroid peroxidase (p=0.008) levels were effective on the thyroid elasticity score in the regression model. We detected a SWE cut-off value of 9.68 kPa with 68% sensitivity and 72% specificity, a 70% positive predictive value, and a 69% negative predictive value in thyroid elastography when differentiating between cases with HT and healthy controls. Conclusion: Our results show that no metabolic factor other than BMI SDS has any effect on SWE scores, especially in healthy children. There was a positive correlation between BMI SDS and SWE in healthy children (r=0.353; p=0.02), but not in those patients with HT (r=0.196; p=0.19). Likewise, age is another factor affecting SWE only in healthy children. We do not recommend routine evaluation of any laboratory parameters other than thyroid functions before thyroid elastography.

The Effectiveness of Thyroid Elastography in Evaluating Thyroiditis in Children with Type 1 Diabetes

“…In another study in which factors affecting thyroid elastography by comparing children with HT with healthy controls, a positive correlation has been found with age, BMI SDS, and TPOAb. 9 There are other studies in the literature regarding a positive correlation between SWE scores with age and TPOAb. 3 , 10 , 11 In our current study, we observed a positive correlation between thyroid autoantibodies, age or other parameters that increase with age (body weight, height, BMI, thyroid volume), BMI SDS, and SWE scores.…”

“… 3 , 14 , 15 In 1 study, the factors affecting SWE scores in individuals with HT, in the control group, and in the whole group were evaluated separately. 9 Influencing factors were also examined by multivariate regression analysis, and it was observed that only age, BMI SDS, and anti-TPO had an effect on the thyroid elasticity score in the regression model. 9 …”

“… 9 Influencing factors were also examined by multivariate regression analysis, and it was observed that only age, BMI SDS, and anti-TPO had an effect on the thyroid elasticity score in the regression model. 9 …”

Shear-Wave Elastography for the Diagnosis of Pediatric Hashimoto’s Thyroiditis: A Systematic Review and Meta-Analysis

“…Additional thyroid parameters were also measured. Three studies found significantly higher thyroid volume in HT [ 15 - 17 ], two higher TSH levels [ 7 , 8 ], four higher anti-TPO levels [ 7 , 8 , 16 , 17 ], and three anti-TG levels [ 7 , 16 , 17 ]. Additional study characteristics are detailed in Table 1 .…”

Clinical Efficacy and Mechanism of Vitamin D2 in Treating Hashimoto’s Thyroiditis

“…Hashimoto’s thyroiditis (HT) is one of the most prevalent autoimmune diseases, with the highest incidence rate among autoimmune thyroid disorders. 1 Studies have revealed the annually increasing incidence of HT. In China, the prevalence of HT ranges from 0.2% to 1.3%.…”