Shear-Wave Elastography—Diagnostic Value in Children with Chronic Autoimmune Thyroiditis

Abstract

Chronic autoimmune thyroiditis (CAT) is the most common thyroid disorder in the pediatric population. Ultrasound evaluation may suggest the diagnosis. Additionally, shear-wave elastography (SWE) proved to be a valuable additional diagnosis tool in adults with CAT by assessing thyroid stiffness (TS). This study aims to assess its use also in detecting children with CAT. The study group consisted of 50 children with confirmed diagnosis of CAT, who were compared to the control group, consisting of 50 children with no thyroid pathology and with an adult group of 50 subjects with CAT. The evaluation included, besides bioimmunochemical evaluation, also thyroid ultrasound evaluation and elastography measurements in the same session (Aixplorer Mach 30, Supersonic imagine, France). The mean TS values were significantly lower for children in the CAT group compared to adults with CAT (15.51 ± 4.76 kPa vs. 20.96 ± 6.31 kPa; p < 0.0001) and higher compared to the healthy aged matched controls (15.51 ± 4.76 kPa vs. 10.41 ± 2.01 kPa; p < 0.0001). SWE elastography definitely seems a promising technique in the evaluation of children with autoimmune thyroid pathology.

Ultrasound elastography in children — nice to have for scientific studies or arrived in clinical routine?

“…Both strain imaging and shear wave elastography were used for autoimmune thyroiditis. In children, a significantly higher shear wave velocity and thus higher stiffness were found compared to children without pathology [ 4 , 11 ]. Children with type I diabetes mellitus show a significant lower shear wave velocity [ 49 ].…”

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

“…Our analysis had originally hoped to determine diagnostic cut-off values of SWE to further analyze the clinical value of this technique; unfortunately, only two studies reported this information. Cepeha et al found a cut-off value of 12.2 kPa yielded a sensitivity of 82% and specificity of 88% for diagnosing chronic autoimmune thyroiditis in children [16]. Similarly, Kandemirli et al noted a cut-off value of 12.3 kPa afforded a sensitivity of 86.4 and specificity of 96.3% [15].…”

“…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 .…”

“…Cepeha et al. found a cut-off value of 12.2 kPa yielded a sensitivity of 82% and specificity of 88% for diagnosing chronic autoimmune thyroiditis in children [ 16 ]. Similarly, Kandemirli et al.…”

The Non-Invasive Ultrasound-Based Assessment of Liver Viscosity in a Healthy Cohort

“…Elasticity is illustrated as a color-coded elastogram, enabling both a qualitative and quantitative LS estimation. Several studies ascertained the usefulness of 2D-SWE in assessing the stiffness of different organs such as the liver, spleen, or thyroid [ 5 , 7 , 8 , 9 , 10 ].…”