Value of two-dimensional shear wave elastography quantitative analysis for evaluation of thyroid function in first trimester pregnancy

Thyroid dysfunction during pregnancy is an important disease affecting the health of mothers and children. Two-dimensional (2D) shear wave elastography (SWE) is the newest ultrasonic elastography technology and its value in differentiating benign and malignant thyroid nodules has been widely recognized. However, the value of 2D SWE in evaluating and predicting thyroid function is unclear.

To explore prospectively the value of 2D SWE quantitative analysis for the evaluation of thyroid function in the first trimester.

We included outpatients of reproductive age in the Department of Gynecology in Shanghai Changning Maternity and Infant Health Hospital between March 2023 and March 2024 who had conventional ultrasound examination and 2D SWE of the thyroid. They also underwent transvaginal ultrasound examination to confirm early intrauterine pregnancy and serum thyroid stimulating hormone (TSH) level was measured. The patients were divided into pregnant with normal TSH, pregnant with abnormal TSH, and nonpregnant with normal TSH. Conventional ultrasound and 2D SWE results were compared among the three groups.

A total of 108 patients were included in the study; 57 in the pregnant with normal TSH group, 18 in the pregnant with abnormal TSH group and 33 were in the nonpregnant with normal TSH group. Thyroid size, thyroid echotexture, 2D SWE quantitative parameters including mean elasticity in the region of interest and maximal elasticity in the region of interest showed no significant differences among the three groups (P > 0.05).

Conventional ultrasound and 2D SWE features could not reflect the level of serum TSH.