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Can thyroid elastography with ultrasound be used to stage children with Hashimoto's thyroiditis?
Serkan Bilge Koca1, Turgut Seber2
1Department of Pediatrics, Division of Pediatric Endocrinology, Health Sciences University, Kayseri City Hospital, Kayseri, Türkiye.
Insights
Shear wave elastography (SWE) reveals increased thyroid stiffness in children with Hashimoto
Area of Science:
- Pediatric Endocrinology
- Medical Imaging
- Rheumatology
Background:
- Hashimoto's thyroiditis (HT) is an autoimmune condition affecting the thyroid gland.
- Thyroid stiffness can be an indicator of thyroid inflammation and disease progression.
- Shear wave elastography (SWE) is a non-invasive imaging technique to assess tissue stiffness.
Purpose of the Study:
- To evaluate thyroid parenchyma stiffness using SWE in pediatric patients with Hashimoto's thyroiditis (HT).
- To compare SWE measurements between children with HT and healthy controls.
- To correlate SWE scores with the stage of thyroiditis and thyroid function in children with HT.
Main Methods:
- A study included 130 children diagnosed with HT and 46 healthy children as controls.
- Thyroid ultrasonography was performed to assess thyroiditis stages.
- Shear wave elastography (SWE) was utilized to measure thyroid parenchyma stiffness in kilopascals (kPa).
Main Results:
- SWE scores were significantly higher in children with HT compared to healthy controls.
- Thyroid stiffness, measured by SWE, increased progressively with advancing stages of thyroiditis in the HT group (p<0.001).
- Elevated SWE scores were observed in both hypothyroid and euthyroid children with HT compared to controls.
Conclusions:
- Thyroid parenchyma stiffness, as measured by SWE, is significantly elevated in children with Hashimoto's thyroiditis.
- SWE scores correlate with the severity of thyroiditis, increasing with disease stage.
- SWE is a valuable tool for assessing thyroid inflammation in pediatric Hashimoto's thyroiditis.
Objectives:
We aimed to evaluate the stiffness of the thyroid parenchyma with Shear wave elastography (SWE) in children with Hashimoto's thyroiditis (HT) and healthy controls.
Methods:
A total of 130 children with HT and 46 healthy controls were included in this study. The clinical and laboratory characteristics of the groups, thyroiditis stages in thyroid ultrasonography, and SWE scores which was obtained as kilopascal (kPa), were analysed.
Results:
We observed that SWE scores were significantly higher in children with HT compared to healthy controls, and SWE scores increased significantly in HT group, as the thyroiditis stage increased (p<0.001). Median, 1st (Q1) and 3rd (Q3) quartiles of SWE scores were as follows; healthy control: 7.4 kPa (6-10.6), stage 1 HT: 9.6 kPa (7.4-11.2), stage 2 HT: 15.2 kPa (10.8-19.9), stage 3 HT: 17.9 kPa (13.7-25.8), (p<0.001). Children with HT were divided into subgroups according to serum TSH and free T4 levels as euthyroid (103; 79.2% of children), euthyroid but subclinical TSH elevation (7; 5.4% of children), hypothyroidism (11; 8.5% of children) and hyperthyroidism (9; 6.9% of children). The SWE scores were significantly higher in children with hypothyroidism with HT compared to healthy controls 17.9 kPa (13.6-27.5) vs. 7.4 kPa (6-10.6), and in euthyroid children with HT compared to healthy controls 11.5 kPa (9.2-15.6) vs. 7.4 kPa (6-10.6), (p=0.006 and p<0.001, respectively).
Conclusions:
The SWE scores increase as the thyroiditis stage increases in children with HT. There was no significant difference in SWE scores between stage 2 and stage 3 thyroiditis.
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