Thyroid sonoelastography in paediatrics: A comparison between healthy and diffuse thyroid disease

Shear wave elastography has been increasingly used as a supplementary tool to assess diffuse thyroid disease. This study aimed to evaluate thyroid shear wave velocity in healthy children, determine the optimal number of shear wave velocity measurements and establish a diagnostic cut-off value to aid in the detection of diffuse thyroid disease.

We retrospectively analysed children (<16 years) who underwent thyroid ultrasound between 2019 and 2021. Both those with and without thyroid pathology were included consecutively. Shear wave elastography was performed, and 6 and 10 shear wave velocity measurements (m/s) were obtained from the right and left lobes, respectively. Analyses included Student's t-test, Pearson's correlation, receiver operating characteristic curve and Fagan nomogram.

Of 194 children, 144 controls had normal ultrasound findings, while 50 diffuse thyroid disease cases showed echostructural abnormalities in 84%. Shear wave velocity was higher in the diffuse thyroid disease group (2.09 ± 0.34 (1.42-2.88) m/s) than controls (1.75 ± 0.21 (1.38-2.47) m/s) (p < 0.001). The area under the curve was 0.805 ± 0.041 (0.725-0.884); shear wave velocity < 1.75 m/s was associated with a low probability of diffuse thyroid disease (8% (4-14%)). Accuracy fell significantly when measurements were reduced from 10 to 6 (p < 0.001). No laboratory tests confirmed euthyroid status in controls.

Ten shear wave velocity measurements were recommended for optimal shear wave elastography evaluation. A shear wave velocity < 1.75 m/s suggested a low probability of diffuse thyroid disease.