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Roi CM, Borlea A, Mihuta MS, Paul C, Stoian D. A Comparative Analysis of Strain and 2D Shear Wave Elastography in the Diagnosis of Autoimmune Thyroiditis in Pediatric Patients. Biomedicines 2023; 11:1970. [PMID: 37509609 PMCID: PMC10376998 DOI: 10.3390/biomedicines11071970] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 06/29/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023] Open
Abstract
This paper aims to assess the usefulness of shear-wave elastography (SWE) and strain elastography (SE) for identifying and monitoring thyroid gland changes in children diagnosed with chronic autoimmune thyroiditis (CAT). Our study included 77 children between the ages of six and eighteen. Of these, 45 were diagnosed with CAT, while 32 had no thyroid pathology. Following a clinical examination and laboratory tests, an ultrasound was carried out, and then a SE (using a Hitachi Preirus machine) and SWE (using an Aixplorer Mach 30, Supersonic imagine, France) were performed in the same session. The median thyroid elastic index (EI) in the CAT group was 13.8 (13.3-17) kPa compared to 10.1 (9.3-11.2) kPa in healthy children (p < 0.0001). We found a median strain ratio (SR) of 1.2 (1.2-1.3) for CAT compared to 0.7 (0.6-0.9) for healthy thyroid tissue (p < 0.0001). The optimal cut-off value for predicting the presence of CAT in children using SR was >1 (Se = 82.2%, Sp = 87.5%, PPV = 90.2%, and NPV = 77.8%, AUROC = 0.850), while using SWE, the optimal cut-off value for predicting the presence of CAT in children was >12 kPa (Se = 88.9%, Sp = 93.7%, PPV = 95.2%, and NPV = 85.5%, AUROC = 0.943). Both techniques are useful for measuring thyroid tissue elasticity, and their diagnostic accuracy and reliability are comparable.
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Affiliation(s)
- Cristina Mihaela Roi
- Department of Doctoral Studies, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Andreea Borlea
- Department of Internal Medicine II, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Monica Simina Mihuta
- Department of Doctoral Studies, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Corina Paul
- Department of Pediatrics, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Dana Stoian
- Department of Internal Medicine II, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
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Decker T, Schnittka E, Stolzenberg L, Yalowitz J. Shear-Wave Elastography for the Diagnosis of Pediatric Hashimoto’s Thyroiditis: A Systematic Review and Meta-Analysis. Cureus 2023; 15:e35490. [PMID: 37007310 PMCID: PMC10049949 DOI: 10.7759/cureus.35490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 02/26/2023] [Indexed: 02/27/2023] Open
Abstract
Shear-wave elastography (SWE) has emerged as a novel ultrasonographic technique for the diagnosis of pediatric Hashimoto's Thyroiditis (HT). This systematic review and meta-analysis aim to summarize current evidence to determine the diagnostic value of SWE for HT. MEDLINE, a comprehensive search yielded five studies inclusive of 392 subjects. A meta-analysis comparing SWE values (kPa) between children with HT and healthy controls yielded a Cohen's d-value of 1.34 (CI 1.02-1.65), suggesting statistically significant differences in SWE values. Such evidence indicates that SWE may serve as a valuable tool in diagnosing HT in the pediatric population.
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Agarwal D, Bhatia A, Saxena AK, Dayal D, Sodhi KS. Role of Shear Wave Elastography of Thyroid Gland in Children With Newly Diagnosed Hashimoto's Thyroiditis: Preliminary Study. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2022; 41:2217-2225. [PMID: 34862654 DOI: 10.1002/jum.15903] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 11/21/2021] [Accepted: 11/22/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES The data on the use of shear wave elastography (SWE) in children with thyroid disorders is limited. We aimed to assess the role of SWE in the evaluation of the thyroid gland in children newly diagnosed with Hashimoto's thyroiditis (HT). METHODS The thyroid gland was evaluated in 18 children (5 boys and 13 girls, age range: 5-12 years) with newly diagnosed HT and 27 (21 boys and 6 girls, age range: 4-12 years) healthy controls using grayscale ultrasound followed by SWE. The values of SWE (in kPa) were compared between cases and controls and were also correlated with various demographic variables and serum thyroid hormone concentrations. RESULTS The overall median of SWE values in cases and controls was 20.6 kPa (IQR = 19.16-26.94) and 10.7 kPa (IQR = 9.9-16.32), respectively, and the difference was statistically significant (W = 438.5, P < .001). There was a moderate positive correlation between serum triiodothyronine concentrations and SWE (ρ = 0.57, P = .016) and a moderate negative correlation between serum thyroid stimulating hormone concentrations and SWE (ρ = -0.54, P = .020). A significant difference (W = 61.0, P = .003) was also seen in median SWE of the thyroid gland between boys (median: 29.63 kPa, IQR = 27.53-32.88) and girls (median: 19.43 kPa, IQR = 18.88-21.32). CONCLUSION There is a significant difference between SWE values of thyroid in normal children and children with newly diagnosed HT. Hence, SWE may be used as a noninvasive imaging technique in distinguishing normal and abnormal thyroid gland at an early stage. We suggest larger studies to confirm our preliminary findings of SWE in pediatric HT.
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Affiliation(s)
- Divij Agarwal
- Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Anmol Bhatia
- Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Akshay K Saxena
- Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Devi Dayal
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Kushaljit S Sodhi
- Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Popa A, Sporea I, Bende F, Popescu A, Fofiu R, Borlea A, Bâldea V, Pascu A, Foncea CG, Cotrău R, Șirli R. The Non-Invasive Ultrasound-Based Assessment of Liver Viscosity in a Healthy Cohort. Diagnostics (Basel) 2022; 12:diagnostics12061451. [PMID: 35741261 PMCID: PMC9222204 DOI: 10.3390/diagnostics12061451] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 06/08/2022] [Accepted: 06/11/2022] [Indexed: 12/11/2022] Open
Abstract
Liver fibrosis is the most significant prognostic factor in chronic liver disease (CLD). Clinical practice guidelines recommend the use of non-invasive techniques, such as two-dimensional shear-wave elastography (2D-SWE), to assess liver stiffness as a marker of fibrosis. Several other factors influence liver stiffness in addition to liver fibrosis. It is presumed that changes due to necro-inflammation modify the propagation of shear waves (dispersion). Therefore, new imaging techniques that investigate the dispersion properties of shear waves have been developed, which can serve as an indirect method of measuring liver viscosity (Vi PLUS). Defining the reference values in healthy subjects among different age groups and genders and analyzing the factors that influence these values is essential. However, published data on liver viscosity are still limited. This is the first study that aimed to assess the normal range of liver viscosity values in subjects with healthy livers and analyze the factors that influence them. One hundred and thirty-one consecutive subjects with healthy livers were enrolled in this prospective study. The results showed that Vi PLUS is a highly feasible method. Liver stiffness, age and BMI influenced the liver viscosity values. The mean liver viscosity by Vi PLUS in subjects with healthy livers was 1.59 Pa·s.
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Affiliation(s)
- Alexandru Popa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine II, Center for Advanced Research in Gastroenterology and Hepatology, “Victor Babes” University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania; (A.P.); (I.S.); (F.B.); (A.P.); (V.B.); (A.P.); (C.G.F.); (R.C.); (R.Ș.)
| | - Ioan Sporea
- Division of Gastroenterology and Hepatology, Department of Internal Medicine II, Center for Advanced Research in Gastroenterology and Hepatology, “Victor Babes” University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania; (A.P.); (I.S.); (F.B.); (A.P.); (V.B.); (A.P.); (C.G.F.); (R.C.); (R.Ș.)
| | - Felix Bende
- Division of Gastroenterology and Hepatology, Department of Internal Medicine II, Center for Advanced Research in Gastroenterology and Hepatology, “Victor Babes” University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania; (A.P.); (I.S.); (F.B.); (A.P.); (V.B.); (A.P.); (C.G.F.); (R.C.); (R.Ș.)
| | - Alina Popescu
- Division of Gastroenterology and Hepatology, Department of Internal Medicine II, Center for Advanced Research in Gastroenterology and Hepatology, “Victor Babes” University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania; (A.P.); (I.S.); (F.B.); (A.P.); (V.B.); (A.P.); (C.G.F.); (R.C.); (R.Ș.)
| | - Renata Fofiu
- Division of Gastroenterology and Hepatology, Department of Internal Medicine II, Center for Advanced Research in Gastroenterology and Hepatology, “Victor Babes” University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania; (A.P.); (I.S.); (F.B.); (A.P.); (V.B.); (A.P.); (C.G.F.); (R.C.); (R.Ș.)
- Correspondence: ; Tel.: +40-756-931-086
| | - Andreea Borlea
- Division of Endocrinology, Department of Internal Medicine II, “Victor Babes” University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania;
| | - Victor Bâldea
- Division of Gastroenterology and Hepatology, Department of Internal Medicine II, Center for Advanced Research in Gastroenterology and Hepatology, “Victor Babes” University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania; (A.P.); (I.S.); (F.B.); (A.P.); (V.B.); (A.P.); (C.G.F.); (R.C.); (R.Ș.)
| | - Ariana Pascu
- Division of Gastroenterology and Hepatology, Department of Internal Medicine II, Center for Advanced Research in Gastroenterology and Hepatology, “Victor Babes” University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania; (A.P.); (I.S.); (F.B.); (A.P.); (V.B.); (A.P.); (C.G.F.); (R.C.); (R.Ș.)
| | - Camelia Gianina Foncea
- Division of Gastroenterology and Hepatology, Department of Internal Medicine II, Center for Advanced Research in Gastroenterology and Hepatology, “Victor Babes” University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania; (A.P.); (I.S.); (F.B.); (A.P.); (V.B.); (A.P.); (C.G.F.); (R.C.); (R.Ș.)
| | - Radu Cotrău
- Division of Gastroenterology and Hepatology, Department of Internal Medicine II, Center for Advanced Research in Gastroenterology and Hepatology, “Victor Babes” University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania; (A.P.); (I.S.); (F.B.); (A.P.); (V.B.); (A.P.); (C.G.F.); (R.C.); (R.Ș.)
| | - Roxana Șirli
- Division of Gastroenterology and Hepatology, Department of Internal Medicine II, Center for Advanced Research in Gastroenterology and Hepatology, “Victor Babes” University of Medicine and Pharmacy, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania; (A.P.); (I.S.); (F.B.); (A.P.); (V.B.); (A.P.); (C.G.F.); (R.C.); (R.Ș.)
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Mentzel HJ, Glutig K, Gräger S, Krüger PC, Waginger M. Ultrasound elastography in children - nice to have for scientific studies or arrived in clinical routine? Mol Cell Pediatr 2022; 9:11. [PMID: 35668217 PMCID: PMC9169959 DOI: 10.1186/s40348-022-00143-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 04/01/2022] [Indexed: 12/12/2022] Open
Abstract
Ultrasound elastography (USE) is a modality that in addition to fundamental B-mode, Doppler, and contrast-enhanced sonography is suitable to make qualitative and quantitative statements about the stiffness of tissues. Introduced more than 20 years ago in adults, USE becomes now a diagnostic tool also in children. The aim of this paper is to describe current available techniques for USE in children. The significance for routine use in children is shown, and further interesting applications are reported.
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Affiliation(s)
- Hans-Joachim Mentzel
- Section of Pediatric Radiology, Department of Radiology, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany.
| | - Katja Glutig
- Section of Pediatric Radiology, Department of Radiology, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany
| | - Stephanie Gräger
- Section of Pediatric Radiology, Department of Radiology, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany
| | - Paul-Christian Krüger
- Section of Pediatric Radiology, Department of Radiology, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany
| | - Matthias Waginger
- Section of Pediatric Radiology, Department of Radiology, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany
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Basaran MK, Gurkan O. Analysis of Thyroid Gland Problems with Shear Wave Elastography in Children with Celiac Disease. Curr Med Imaging 2022; 18:1106-1112. [PMID: 35331120 DOI: 10.2174/1573405618666220324113359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/27/2021] [Accepted: 01/31/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND The rate of autoimmune thyroiditis in children with celiac disease (CD) is high relative to the normal population. Since the majority of these patients are also euthyroid, thyroid imaging methods are gaining significance in diagnosis and follow-up. This study examines the effectiveness of thyroid ultrasonography (US) and thyroid shear wave elastography (SWE) in diagnosing thyroid disease in children with CD. MATERIALS AND METHODS This cross-sectional controlled study analyzed thyroid US, SWE, serum thyroid function tests, and thyroid autoimmune antibodies of 106 CD patients and 103 control patients without CD. An Aplio 500 ultrasound device with a linear array transducer and elastography software was used for thyroid US and SWE measurement of all patients. RESULTS Right lobe thyroid volume, left lobe thyroid volume, total thyroid volume, thyroid mean elasticity (m/s), right lobe elasticity (kPa), left lobe elasticity (kPa), and mean thyroid elasticity (kPa) levels of the CD group were higher than those of the control group (p < 0.001). The relationships between thyroid US and thyroid mean elasticity (m/s), thyroid mean elasticity (kPa), anti-thyroid peroxidase antibody, and thyroid-stimulating hormone were positive and moderate, respectively (r = 0.612, 0.612, 0.636, and 0.565, respectively; p < 0.001). CONCLUSION In this study, SWE findings were compatible with laboratory findings, as they constituted a sensitive and useful method in the diagnosis and follow-up of autoimmune thyroid disease in children with CD.
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Affiliation(s)
- Meryem Keceli Basaran
- Department of Pediatrics, Division of Pediatric Gastroenterology, Gaziosmanpasa Training and Research Hospital, İstanbul, Turkey
| | - Okan Gurkan
- Department of Radiology, Gaziosmanpasa Training and Research Hospital, İstanbul, Turkey
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Zymnia KO. ASSESSMENT OF ULTRASONOGRAPHIC SIGNS OF AUTOIMMUNE THYROIDITIS VALIDITY BASED ON THE HISTOPATHOLOGIC EXAMINATION RESULTS. BULLETIN OF PROBLEMS BIOLOGY AND MEDICINE 2022. [DOI: 10.29254/2077-4214-2022-3-166-205-209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Shear Wave Velocity Estimation Using the Real-Time Curve Tracing Method in Ultrasound Elastography. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11052095] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The estimation of shear wave velocity is very important in ultrasonic shear wave elasticity imaging (SWEI). Since the stability and accuracy of ultrasonic testing equipment have been greatly improved, in order to further improve the accuracy of shear wave velocity estimation and increase the quality of shear wave elasticity maps, we propose a novel real-time curve tracing (RTCT) technique to accurately reconstruct the motion trace of shear wave fronts. Based on the curve fitting of each frame shear wave, the propagation velocity of two-dimensional shear waves can be estimated. In this paper, shear wave velocity estimation and shear wave image reconstruction are implemented for homogeneous regions and stiff spherical inclusion regions with different elasticity, respectively. The experimental result shows that the proposed shear wave velocity estimation method based on the real-time curve tracing method has advantages in accuracy and anti-noise performance. Moreover, by eliminating artifacts of shear wave videos, the velocity map acquired can restore the shape of inclusions better. The real-time curve tracing method can provide a new idea for the estimation of shear wave velocity and elastic parameters.
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