Preliminary study of sound touch elastography in diffuse thyroid disease in children

Area of Science:

• Pediatric Endocrinology
• Radiology
• Medical Imaging

Background:

• Diffuse thyroid disease (DTD) diagnosis in children requires accurate imaging techniques.
• Conventional ultrasound and Doppler are standard, but differentiating specific DTD types can be challenging.

Purpose of the Study:

• To evaluate the efficacy of sound touch elastography (STE) combined with conventional ultrasound for diagnosing DTD in pediatric patients.
• To compare STE findings with Doppler ultrasound parameters in differentiating DTD from normal thyroids.

Main Methods:

• Retrospective review of ultrasound (gray scale, Doppler, STE) and serum tests in 62 children with DTD and 30 healthy controls.
• Analysis of STE-Mean values and peak systolic velocity (PSV) of the superior thyroid artery.

Main Results:

• STE-Mean values were significantly higher in children with DTD (19.35 ± 5.00 kPa for Graves' disease, 19.43 ± 6.06 kPa for Hashimoto's thyroiditis) compared to normal controls (11.24 ± 1.99 kPa).
• STE effectively differentiated DTD from normal thyroids (AUC 0.945).
• Superior thyroid artery PSV showed high accuracy in separating DTD from normal (AUC 0.992) and differentiating GD/HT (AUC 0.864), correlating with FT3 and FT4 levels.

Conclusions:

• STE indicates increased thyroid stiffness in pediatric DTD.
• STE alone has limited specificity for differentiating Graves' disease from Hashimoto's thyroiditis.
• Superior thyroid artery flow velocity measurements can complement STE for improved differential diagnosis of DTD in children.