The Value of Ultrasound Elastography in Diffuse Thyroid Disease among a Sample of Iraqi Population

Authors

  • Hiba Mohammed Abdulwahid Department of Radiology, College of Medicine, University of Baghdad, Baghdad, Iraq
  • Lubna Ali Hussein Department of Radiology, Kamal al-Samaraai Specialist Hospital, Baghdad, Iraq
  • Areege Mustafa Kamal Department of Histopathology, Oncology Teaching Hospital, Medical City, Baghdad, Iraq

DOI:

https://doi.org/10.3889/oamjms.2021.6060

Keywords:

Diffuse thyroiditis diseases, Ultrasound elastography, Strain ratio

Abstract

Abstract

Background: Early detection of many thyroid disorders is essential in the management. Ultrasound elastography is beneficial in the assessment of diffuse thyroid diseases.     

Aim of study: To assess the role of ultrasound strain elastography in the diagnosis of diffuse non nodular thyroid disease in comparison to healthy controls and in the characterization and differentiation of the types of diffuse thyroid diseases.

Patients and methods: It is a prospective analytic study performed in the Radiology Department of Oncology Teaching Hospital/Medical city Complex in Baghdad during the period from 1st of December 2019 to 30th of June, 2020 on convenient sample of 25 patients with diffuse thyroid disease, in addition to a sample of 25 healthy control persons. The diagnosis of diffuse thyroid diseases was made by combination of clinical symptoms, laboratory investigations and thyroid ultrasound.

Results: The mean elastography strain ratio (1.36) of patients with diffuse thyroid disease was significantly higher than (0.82) mean of elastography strain ratio for healthy control persons (p<0.001). The acceptable cutoff elastography strain ratio in the diagnosis of diffuse thyroid disease was 0.89 with validity results (80% sensitivity, 70% specificity and 75% accuracy). The mean elastography strain ratio for patients with Hashimotos thyroiditis was significantly higher than the strain ratio of patients with Graves disease (p=0.002).

Conclusions: The ultrasound elastography is useful in the assessment and characterization of diffuse thyroid disease. The ultrasound elastography strain ratio value is helpful in differentiation between different diffuse thyroid diseases especially between Hashimotos thyroiditis and Graves's disease

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References

Ahn HS, Kim DW, Lee YJ, Baek HJ, Ryu JH. Diagnostic accuracy of real-time sonography in differentiating diffuse thyroid disease from normal thyroid parenchyma: A multicenter study. AJR Am J Roentgenol. 2018;211(3):649-54. https://doi.org/10.2214/ajr.17.19164 PMid:29995502 DOI: https://doi.org/10.2214/AJR.17.19164

Korkmaz AA, Baki G, Kose M, Cobanoglu YB. Value of real-time and strain ratio elastography in differential diagnosis of graves’ disease and subacute and hashimoto’s thyroiditis. Iran J Radiol. 2017;14(4):e22019. https://doi.org/10.5812/iranjradiol.22019 DOI: https://doi.org/10.5812/iranjradiol.22019

Garra BS. Elastography: Current status, future prospects, and making it work for you. Ultrasound Quart. 2011;27(3):177-86. https://doi.org/10.1097/ruq.0b013e31822a2138 PMid:21873855 DOI: https://doi.org/10.1097/RUQ.0b013e31822a2138

Bogazzi F, Bartalena L, Brogioni S, Burelli A, Manetti L, Tanda ML, et al. Thyroid vascularity and blood flow are not dependent on serum thyroid hormone levels: Studies in vivo by color flow Doppler sonography. Eur J Endocrinol. 2005;140(5):452-6. https://doi.org/10.1530/eje.0.1400452 PMid:10229913 DOI: https://doi.org/10.1530/eje.0.1400452

Omori N, Omori K, Takano K. Association of the ultrasonographic findings of subacute thyroiditis with thyroid pain and laboratory findings. Endocr J. 2008;55(3):583-8. https://doi.org/10.1507/endocrj.k07e-163 PMid:18490832 DOI: https://doi.org/10.1507/endocrj.K07E-163

Ruchala M, Szczepanek-Parulska E, Zybek A, Moczko J, Czarnywojtek A, Kaminski G, et al. The role of sonoelastography in acute, subacute and chronic thyroiditis: A novel application of the method. Eur J Endocrinol. 2012;166:425-32. https://doi.org/10.1530/eje-11-0736 PMid:22143319 DOI: https://doi.org/10.1530/EJE-11-0736

Anderson L, Middleton WD, Teefey SA, Reading CC, Langer JE, Desser T, et al. Hashimoto thyroiditis: Part 2, sonographic analysis of benign and malignant nodules in patients with diffuse Hashimoto thyroiditis. AJR Am J Roentgenol. 2010;195(1):216-22. https://doi.org/10.2214/ajr.09.3680 PMid:20566819 DOI: https://doi.org/10.2214/AJR.09.3680

Sporea I, Vlad M, Bota S, Sirli RL, Popescu A, Danila M, et al. Thyroid stiffness assessment by acoustic radiation force impulse elastography (ARFI). Ultraschall Med. 2011;32(3):281-5. https://doi.org/10.1055/s-0029-1246048 PMid:21321841 DOI: https://doi.org/10.1055/s-0029-1246048

Lee JG. Chronic nonspecific thyroiditis. Arch Surg. 1935;31(6):982-1012. DOI: https://doi.org/10.1001/archsurg.1935.01180180134006

Zhao CK, Xu HX. Ultrasound elastography of the thyroid: Principles and current status. Ultrasonography. 2019;38(2):106-24. https://doi.org/10.14366/usg.18037 PMid:30690960 DOI: https://doi.org/10.14366/usg.18037

Al-Hashimi AM. Hashimoto’s thyroiditis: A personal experience. QMJ. 2014;10(17):248-52.

Yang Z, Zhang H, Wang K, Cui G, Fu F. Assessment of diffuse thyroid disease by strain ratio in ultrasound elastography. Ultrasound Med Biol. 2015;41(11):2884-9. https://doi.org/10.1016/j.ultrasmedbio.2015.07.012 PMid:26306430 DOI: https://doi.org/10.1016/j.ultrasmedbio.2015.07.012

Dighe M, Bae U, Richardson ML, Dubinsky TJ, Minoshima S, Kim Y. Differential diagnosis of thyroid nodules with US elastography using carotid artery pulsation. Radiology. 2008;248:662-9. https://doi.org/10.1148/radiol.2482071758 PMid:18539888 DOI: https://doi.org/10.1148/radiol.2482071758

Vorländer C, Wolff J, Saalabian S, Lienenlüke RH, Wahl RA. Real-time ultrasound elastography--a noninvasive diagnostic procedure for evaluating dominant thyroid nodules. Langenbecks Arch Surg. 2010;395(7):865-71. https://doi.org/10.1007/s00423-010-0685-3 PMid:20632029 DOI: https://doi.org/10.1007/s00423-010-0685-3

Menzilcioglu MS, Duymus M, Gungor G, Citil S, Sahin T, Boysan SN, et al. The value of real-time ultrasound elastography in chronic autoimmune thyroiditis. Br J Radiol. 2014;87(1044):20140604. https://doi.org/10.1259/bjr.20140604 PMid:25315887 DOI: https://doi.org/10.1259/bjr.20140604

Cantisani V, Lodise P, Grazhdani H, Mancuso E, Maggini E, Di Rocco G, et al. Ultrasound elastography in the evaluation of thyroid pathology. Current status. Eur J Radiol. 2014;83(3):420-8. https://doi.org/10.1016/j.ejrad.2013.05.008 PMid:23763859 DOI: https://doi.org/10.1016/j.ejrad.2013.05.008

Çekiç B, Parlak AE, Koksel Y, Toslak IE, Parlak M. Real-time ultrasound elastography evaluation of the thyroid gland in adolescent patients with hashimoto thyroiditis. Biomed Res. 2017;28(17):7534-9.

Marcocci C, Vitti P, Cetani F, Catalano F, Concetti R, Pinchera A. Thyroid ultrasonography helps to identify patients with diffuse lymphocytic thyroiditis who are prone to develop hypothyroidism. J Clin Endocrinol Metab. 1991;72(1):209-13. https://doi.org/10.1210/jcem-72-1-209 PMid:1986019 DOI: https://doi.org/10.1210/jcem-72-1-209

Ohmori N, Miyakawa M, Ohmori K, Takano K. Ultrasonographic findings of papillary thyroid carcinoma with Hashimoto’s thyroiditis. Intern Med. 2007;46(9):547-50. https://doi.org/10.2169/internalmedicine.46.1901 PMid:17473486 DOI: https://doi.org/10.2169/internalmedicine.46.1901

Set PA, Oleszczuk-Raschke K, von Lengerke JH, Bramswig J. Sonographic features of Hashimoto thyroiditis in childhood. Clin Radiol. 1996;51(3):167-9. https://doi.org/10.1016/s0009-9260(96)80317-5 PMid:8605745 DOI: https://doi.org/10.1016/S0009-9260(96)80317-5

Singh B, Shaha AR, Trivedi H, Carew JF, Poluri A, Shah JP. Coexistent Hashimoto’s thyroiditis with papillary thyroid carcinoma: Impact on presentation, management, and outcome. Surgery. 1999;126(6):1070-6. https://doi.org/10.1067/msy.2099.101431 PMid:10598190 DOI: https://doi.org/10.1067/msy.2099.101431

Park M, Park SH, Kim EK, Yoon JH, Moon HJ, Lee HS, et al. Heterogeneous echogenicity of the underlying thyroid parenchyma: How does this affect the analysis of a thyroid nodule? BMC Cancer. 2013;13:550. https://doi.org/10.1186/1471-2407-13-550 PMid:24237991 DOI: https://doi.org/10.1186/1471-2407-13-550

Kwak JY, Han KH, Yoon JH, Moon HJ, Son EJ, Park SH, et al. Thyroid imaging reporting and data system for US features of nodules: A step in establishing better stratification of cancer risk. Radiology. 2011;260(3):892-9. https://doi.org/10.1148/radiol.11110206 PMid:21771959 DOI: https://doi.org/10.1148/radiol.11110206

Kwak JY, Koo H, Youk JH, Kim MJ, Moon HJ, Son EJ, et al. Value of US correlation of a thyroid nodule with initially benign cytologic results. Radiology. 2010;254(1):292-300. https://doi.org/10.1148/radiol.2541090460 DOI: https://doi.org/10.1148/radiol.2541090460

Rosário PW, Bessa B, Valadão MM, Purisch S. Natural history of mild subclinical hypothyroidism: Prognostic value of ultrasound. Thyroid. 2009;19(1):9-12. https://doi.org/10.1089/thy.2008.0221 PMid:19021461 DOI: https://doi.org/10.1089/thy.2008.0221

Shin D, Kim E, Lee E. Role of ultrasonography in outcome prediction in subclinical hypothyroid patients treated with levothyroxine. Endocr J. 2010;57(1):15. https://doi.org/10.1507/endocrj.k09e-154 PMid:19823000 DOI: https://doi.org/10.1507/endocrj.K09E-154

Gietka-Czernel M, Kochman M, Bujalska K, StachlewskaNasfeter E, Zgliczynski W. Real-time ultrasound elastography-a new tool for diagnosing thyroid nodules. Endokrynol Pol. 2010;61(6):652-7. PMid:21104638

Menzilcioglu MS, Duymus M, Avcu S. Sonographic elastography of the thyroid gland. Pol J Radiol. 2016;81:152-6. https://doi.org/10.12659/pjr.896178 PMid:27103947 DOI: https://doi.org/10.12659/PJR.896178

Cantisani V, Grazhdani H, Drakonaki E, D’Andrea V, Di Segni M, Kaleshi E, et al. Elastography for the characterization of thyroid nodules: Advantages and limitation. Int J Endocrinol. 2015;2015:908575. https://doi.org/10.1155/2015/908575 PMid:25954310 DOI: https://doi.org/10.1155/2015/908575

Iddah MA, Macharia BN. Autoimmune thyroid disorders. ISRN Endocrinol. 2013;2013:509764. https://doi.org/10.1155/2013/509764 PMid:23878745 DOI: https://doi.org/10.1155/2013/509764

Pishdad P, Pishdad GR, Tavanaa S, Pishdad R, Jalli R. Thyroid ultrasonography in differentiation between graves’ disease and hashimoto’s thyroiditis. J Biomed Phys Eng. 2017;7:21-6. https://doi.org/10.1089/thy.2010.0386 PMid:28451576 DOI: https://doi.org/10.1089/thy.2010.0386

Hefeda MM. Value of the new elastography technique using acoustic radiation force impulse in differentiation between Hashimoto’s thyroiditis and Graves’ disease. J Clin Imaging Sci. 2019;9:17. https://doi.org/10.25259/jcis-22-2019 PMid:31448168 DOI: https://doi.org/10.25259/JCIS-22-2019

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Published

2021-11-21

How to Cite

1.
Abdulwahid HM, Hussien LA, Kamal AM. The Value of Ultrasound Elastography in Diffuse Thyroid Disease among a Sample of Iraqi Population. Open Access Maced J Med Sci [Internet]. 2021 Nov. 21 [cited 2024 Apr. 19];9(B):1647-53. Available from: https://oamjms.eu/index.php/mjms/article/view/6060

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Radiology and Radiotherapy

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