Thyroid Stiffness Assessment by Acoustic Radiation Force Impulse Elastography (ARFI)

 

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Zusammenfassung

Ziel: Evaluierung und Vergleich der Schilddrüsenelastizität (-Steifheit) bei Patienten ohne bekannte Schilddrüsenerkrankungen, Patienten mit Morbus Graves und mit chronischer autoimmuner Thyreoiditis (CAT). Patienten und Methoden: Unsere prospektive Studie hat 74 Patienten eingeschlossen: 23 ohne Schilddrüsenerkrankungen, 29 mit Morbus Graves und 22 mit chronischer autoimmuner Thyreoiditis (CAT), die durch spezifische Methoden diagnostiziert wurden. Bei allen Patienten wurden jeweils 10 ARFI-Messungen durch einen konvexen 2 – 6 MHZ-Schallkopf im rechten Schilddrüsenlappen und 10 im linken Schilddrüsenlappen durchgeführt. Die Werte wurden in m/s ausgedrückt und es wurde ein Medianwert berechnet. Wir haben einen Durchschnittswert zwischen den ARFI-Messungen des rechten und des linken Schilddrüsenlappens berechnet. Ergebnisse: Die Steifheit der Schilddrüse war statistisch signifikant niedriger bei gesunden Patienten im Vergleich zu Patienten mit Morbus Graves (2,07 ± 0,44 m/s gegen 2,82 ± 0,47 m/s, p < 0,001) und CAT (2,07 ± 0,44 m/s gegen 2.49 ± 0,48 m/s, p = 0,004). Ebenso haben wir einen statistisch signifikanten Unterschied zwischen Patienten ohne Schilddrüsenerkrankungen und Patienten mit Autoimmunerkrankungen der Schilddrüse (Morbus Graves und CAT zusammen) (2,07 ± 0,44 m/s gegen 2,68 ± 0,50 m/s, p < 0,001). Schlussfolgerung: ARFI scheint eine nutzvolle Methode für die Evaluierung diffuser Schilddrüsenerkrankungen zu sein, die diffuse Schilddrüsenerkrankungen wahrheitsgetreu genug voraussagen kann (AUROC = 0,80).

Abstract

Purpose: To evaluate and compare the values of thyroid tissue elasticity in subjects without known thyroid pathology, in patients with Graves’ disease and with chronic autoimmune thyroiditis (CAT). Patients and Methods: We performed a prospective study that included 74 subjects, 23 without thyroid pathology, 29 with Graves’ disease and 22 with CAT (diagnosed by specific tests). In all patients, 10 elastographic measurements were performed in the right thyroid lobe (RTL) and 10 in the left thyroid lobe (LTL) using a 2 – 6 MHz convex probe. Median values were calculated for each thyroid lobe, measured in meters/second (m/sec). We calculated a mean ARFI value from measurements made in the RTL and LTL. Results: Thyroid stiffness was statistically significant lower in normal subjects vs. those with Graves’ disease (2.07 ± 0.44 m/sec vs. 2.82 ± 0.47 m/sec, p < 0.001) and with CAT (2.07 ± 0.44 m/sec vs. 2.49 ± 0.48 m/sec, p = 0.004). We also found a statistically significant difference between subjects without thyroid pathology and those with autoimmune thyroid pathology (Graves’ disease and CAT) (2.07 ± 0.44 m/sec vs. 2.68 ± 0.50 m/sec, p < 0.001). Conclusion: ARFI seems to be a useful method for the evaluation of diffuse thyroid gland pathology and is able to predict with sufficient accuracy the presence of thyroid diffuse diseases (AUROC = 0.80).

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Prof. Ioan Sporea

Gastroenterology, University of Medicine and Pharmacy Timisoara

Iosif Bulbuca 156

300731 Timisoara

Romania

Phone: ++ 40/2 56/30 94 55

Fax: ++ 49/40/2 56/48 80 03

Email: isporea@umft.ro