Back
 IJCM  Vol.11 No.2 , February 2020
Hashimoto Thyroiditis: Simple Diagnosis with 2D-Shear Wave Elastography
Abstract: Background: Hashimoto thyroiditis diagnosis is primarily established on clinical and laboratory findings; however, some hashimoto thyroiditis cases are euthyroid and seronegative. Moreover, these patients might also have normal conventional ultrasound findings. Aims: In our study, we aimed to distinguish the typical background characteristics of hashimoto thyroiditis using virtual touch tissue imaging quantification maps obtained with acoustic radiation force impulse imaging. Methods: Our study consisted of 28 hashimoto thyroiditis patients without characteristics of ultrasound findings and 28 healthy subjects. The thyroid parenchymal tissue mechanical properties were analyzed with the virtual touch tissue imaging quantification after ultrasound examination, and then related colored maps were obtained. Shear wave velocities were recorded (m/s) from the homogenous area where hardest and softest points were closest to each other on virtual touch tissue imaging quantification maps. The difference between the minimum and maximum shear wave velocities for each case (&Delta;v) was calculated and recorded. Results: Assessment of virtual touch tissue imaging quantification maps revealed a significant difference between hashimoto thyroiditis and control groups in terms of maximum SWV’s, but no significant difference was observed between the minimum shear wave velocities (p < 0.05). Notably, a significant difference was observed when only &Delta;v values were taken into account. In summary, the effects of chronic autoimmune thyroiditis can be distinguished by simply using &Delta;v on virtual touch tissue imaging quantification maps. When the cut-off value of &Delta;v was accepted 0.42, the diagnosis of hashimoto thyroiditis could be made with 88% accuracy. Conclusion: We suggest that shear wave velocities measurement on virtual touch tissue imaging quantification maps is a promising method in equivocal hashimoto thyroiditis cases, in which the diagnosis of hashimoto thyroiditis is unachievable with clinical, laboratory and conventional ultrasound findings.
Cite this paper: Yıldırım, D. , Şanlı, D. , Aliş, D. , Şahin, M. , Bakır, A. and Kılavuz, A. (2020) Hashimoto Thyroiditis: Simple Diagnosis with 2D-Shear Wave Elastography. International Journal of Clinical Medicine, 11, 23-31. doi: 10.4236/ijcm.2020.112003.
References

[1]   Ajjan, R.A. and Weetman, A.P. (2015) The Pathogenesis of Hashimoto’s Thyroiditis: Further Developments in Our Understanding. Hormone and Metabolic Research, 47, 702-710.
https://doi.org/10.1055/s-0035-1548832

[2]   Jaume, J.C. (2007) Endocrine Autoimmunity. In: Greenspan’s Basic & Clinical Endocrinology, Springer, Berlin, 59-79.

[3]   Kumar, V. (2010) 24: The Endocrine System. Robbins and Cotran Pathologic Mechanisms of Disease. 8th Edition, Elsevier, Philadelphia, PA, 1111-1205.

[4]   Tomer, Y. and Huber, A. (2009) The Etiology of Autoimmune Thyroid Disease: A Story of Genes and Environment. Journal of Autoimmunity, 32, 231-239.

[5]   Hiromatsu, Y., Satoh, H. and Amino, N. (2013) Hashimoto’s Thyroiditis: History and Future Outlook. Hormones (Athens), 12, 12-18.
https://doi.org/10.1007/BF03401282

[6]   Effraimidis, G. and Wiersinga, W.M. (2014) Mechanisms in Endocrinology: Autoimmune Thyroid Disease: Old and New Players. European Journal of Endocrinology, 170, 241-252.
https://doi.org/10.1530/EJE-14-0047

[7]   Tasli, F., Özkök, G., Argon, A., et al. (2014) The Role of IgG4 (+) Plasma Cells in the Association of Hashimoto’s Thyroiditis with Papillary Carcinoma. APMIS, 122, 1259-1265.
https://doi.org/10.1111/apm.12297

[8]   Noureldine, S.I. and Tufano, R.P. (2015) Association of Hashimoto’s Thyroiditis and Thyroid Cancer. Current Opinion in Oncology, 27, 21-25.
https://doi.org/10.1097/CCO.0000000000000150

[9]   Chaudhary, V. and Shahina, B. (2013) Thyroid Ultrasound. The Indian Journal of Endocrinology and Metabolism, 17, 219-227.
https://doi.org/10.4103/2230-8210.109667

[10]   Langer, J.E., Khan, A., Nisenbaum, H.L., et al. (2001) Sonographic Appearance of Focal Thyroiditis. American Journal of Roentgenology, 176, 751-754.
https://doi.org/10.2214/ajr.176.3.1760751

[11]   Yeh, H.C., Futterweit, W. and Gilbert, P. (1996) Micronodulation: Ultrasonographic Sign of Hashimoto Thyroiditis. Journal of Ultrasound in Medicine, 15, 813-819.
https://doi.org/10.7863/jum.1996.15.12.813

[12]   Kim, G.R., Kim, E.-K., Kim, S.J., et al. (2016) Evaluation of Underlying Lymphocytic Thyroiditis With Histogram Analysis Using Grayscale Ultrasound Images. Journal of Ultrasound in Medicine, 35, 519-526.

[13]   Nam, S.J., Yoo, J., Lee, H.S., et al. (2016) Quantitative Evaluation for Differentiating Malignant and Benign Thyroid Nodules Using Histogram Analysis of Grayscale Sonograms. Journal of Ultrasound in Medicine, 35, 775-782.

[14]   Magri, F., Chytiris, S., Capelli, V., et al. (2012) Shear Wave Elastography in the Diagnosis of Thyroid Nodules: Feasibility in the Case of Coexistent Chronic Autoimmune Hashimoto’s Thyroiditis. Clinical Endocrinology, 76, 137-141.
https://doi.org/10.1111/j.1365-2265.2011.04170.x

[15]   Han, R., Li, F., Wang, Y., Ying, Z. and Zhang, Y. (2015) Virtual Touch Tissue Quantification (VTQ) in the Diagnosis of Thyroid Nodules with Coexistent Chronic Autoimmune Hashimoto’s Thyroiditis: A Preliminary Study. European Endocrinology, 84, 327-331.
https://doi.org/10.1016/j.ejrad.2014.11.005

[16]   Liu, B., Liang, J., Zhou, L., et al. (2015) Shear Wave Elastography in the Diagnosis of Thyroid Nodules with Coexistent Chronic Autoimmune Hashimoto’s Thyroiditis. Otolaryngology—Head and Neck Surgery, 153, 779-785.
https://doi.org/10.1177/0194599815600149

[17]   Liu, B.-J., Xu, H.-X., Zhang, Y.-F., et al. (2015) Acoustic Radiation Force Impulse Elastography for Differentiation of Benign and Malignant Thyroid Nodules with Concurrent Hashimoto’s Thyroiditis. Medical Oncology, 32, 1-9.

[18]   Bhatia, K.S., Tong, C.S., Cho, C.C., et al. (2012) Shear Wave Elastography of Thyroid Nodules in Routine Clinical Practice: Preliminary Observations and Utility for Detecting Malignancy. European Radiology, 22, 2397-2406.

[19]   Fukuhara, T., Matsuda, E., Izawa, S., Fujiwara, K. and Kitano, H. (2015) Utility of Shear Wave Elastography for Diagnosing Chronic Autoimmune Thyroiditis. Journal of Thyroid Research, 2015, Article ID: 164548.
https://doi.org/10.1155/2015/164548

[20]   Hekimoglu, K., Donmez, F.Y., Arslan, S., et al. (2015) The Role of Shear Wave Elastography in the Diagnosis of Chronic Autoimmune Thyroiditis. Medical Ultrasonography, 17, 322.
https://doi.org/10.11152/mu.2013.2066.173.khu

[21]   Shin, D.Y., Kim, E.-K. and Lee, E.J. (2010) Role of Ultrasonography in Outcome Prediction in Subclinical Hypothyroid Patients Treated with Levothyroxine. Endocrine Journal, 57, 15-22.
https://doi.org/10.1507/endocrj.K09E-154

[22]   Dillman, J.R., Chen, S., Davenport, M.S., et al. (2015) Superficial Ultrasound Shear Wave Speed Measurements in Soft and Hard Elasticity Phantoms: Repeatability and Reproducibility Using Two Ultrasound Systems. Pediatric Radiology, 45, 376-385.

 
 
Top