Cargando…

The Value of Strain Elastography in Predicting Autoimmune Thyroiditis

Chronic autoimmune thyroiditis (CAT) defines a diffuse intrathyroidal lymphocytic infiltration associating a destructive process of the thyroid follicles, most commonly in evolution developing hypothyroidism. Typical ultrasound changes may suggest the presence of the disease. This study aims to eval...

Descripción completa

Detalles Bibliográficos
Autores principales: Cepeha, Cristina Mihaela, Paul, Corina, Borlea, Andreea, Borcan, Florin, Fofiu, Renata, Dehelean, Cristina Adriana, Stoian, Dana
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7692451/
https://www.ncbi.nlm.nih.gov/pubmed/33121150
http://dx.doi.org/10.3390/diagnostics10110874
_version_ 1783614514847023104
author Cepeha, Cristina Mihaela
Paul, Corina
Borlea, Andreea
Borcan, Florin
Fofiu, Renata
Dehelean, Cristina Adriana
Stoian, Dana
author_facet Cepeha, Cristina Mihaela
Paul, Corina
Borlea, Andreea
Borcan, Florin
Fofiu, Renata
Dehelean, Cristina Adriana
Stoian, Dana
author_sort Cepeha, Cristina Mihaela
collection PubMed
description Chronic autoimmune thyroiditis (CAT) defines a diffuse intrathyroidal lymphocytic infiltration associating a destructive process of the thyroid follicles, most commonly in evolution developing hypothyroidism. Typical ultrasound changes may suggest the presence of the disease. This study aims to evaluate the performance of strain elastography in detecting autoimmune thyroiditis as an additional tool to the conventional ultrasound examination. A total of 250 patients were enrolled in the study; 180 had biochemical confirmation of CAT, the other 70 healthy subjects represented the control group. All patients were examined clinically and by means of conventional thyroid ultrasound (US) and real-time elastography using a Hitachi Preirus machine (5–15 MHz linear probe). Five valid measurements for the parenchyma/muscle strain ratios (SR) were taken for each subject, considering the mean value for analysis. A mean SR value above 1.64 was found to predict the presence of CAT with sensitivity (Sen) 69%, specificity p92%, positive predictive value (PPV) 95.4%, negative predictive value (NPV) 54% and area under receiver operating characteristic (AUROC) 0.87. Moreover, when comparing the mean values for SR, significantly higher values were found in CAT patients compared with the controls (2.81 ± 2.11 vs. 1.03 ± 0.51; p < 0.0001). Of the 180 CAT subjects, 92 were on thyroid hormone replacement therapy; significantly higher values were detected for patients under therapy compared with asymptomatic cases (3.45 ± 2.53 vs. 2.15 ± 1.27, p < 0.0001). A cut-off value of 2.94 was established for identifying CAT patients who needed hormonal treatment (Sen 52.3%, Sp 83.7%, PPV 75.4%, NPV 64.7% and AUROC 0.66). No correlation was found between stiffness and antibody titers nor for functional status. Elastography does add valuable information to the US evaluation of cases with autoimmune thyroiditis.
format Online
Article
Text
id pubmed-7692451
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-76924512020-11-28 The Value of Strain Elastography in Predicting Autoimmune Thyroiditis Cepeha, Cristina Mihaela Paul, Corina Borlea, Andreea Borcan, Florin Fofiu, Renata Dehelean, Cristina Adriana Stoian, Dana Diagnostics (Basel) Article Chronic autoimmune thyroiditis (CAT) defines a diffuse intrathyroidal lymphocytic infiltration associating a destructive process of the thyroid follicles, most commonly in evolution developing hypothyroidism. Typical ultrasound changes may suggest the presence of the disease. This study aims to evaluate the performance of strain elastography in detecting autoimmune thyroiditis as an additional tool to the conventional ultrasound examination. A total of 250 patients were enrolled in the study; 180 had biochemical confirmation of CAT, the other 70 healthy subjects represented the control group. All patients were examined clinically and by means of conventional thyroid ultrasound (US) and real-time elastography using a Hitachi Preirus machine (5–15 MHz linear probe). Five valid measurements for the parenchyma/muscle strain ratios (SR) were taken for each subject, considering the mean value for analysis. A mean SR value above 1.64 was found to predict the presence of CAT with sensitivity (Sen) 69%, specificity p92%, positive predictive value (PPV) 95.4%, negative predictive value (NPV) 54% and area under receiver operating characteristic (AUROC) 0.87. Moreover, when comparing the mean values for SR, significantly higher values were found in CAT patients compared with the controls (2.81 ± 2.11 vs. 1.03 ± 0.51; p < 0.0001). Of the 180 CAT subjects, 92 were on thyroid hormone replacement therapy; significantly higher values were detected for patients under therapy compared with asymptomatic cases (3.45 ± 2.53 vs. 2.15 ± 1.27, p < 0.0001). A cut-off value of 2.94 was established for identifying CAT patients who needed hormonal treatment (Sen 52.3%, Sp 83.7%, PPV 75.4%, NPV 64.7% and AUROC 0.66). No correlation was found between stiffness and antibody titers nor for functional status. Elastography does add valuable information to the US evaluation of cases with autoimmune thyroiditis. MDPI 2020-10-27 /pmc/articles/PMC7692451/ /pubmed/33121150 http://dx.doi.org/10.3390/diagnostics10110874 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Cepeha, Cristina Mihaela
Paul, Corina
Borlea, Andreea
Borcan, Florin
Fofiu, Renata
Dehelean, Cristina Adriana
Stoian, Dana
The Value of Strain Elastography in Predicting Autoimmune Thyroiditis
title The Value of Strain Elastography in Predicting Autoimmune Thyroiditis
title_full The Value of Strain Elastography in Predicting Autoimmune Thyroiditis
title_fullStr The Value of Strain Elastography in Predicting Autoimmune Thyroiditis
title_full_unstemmed The Value of Strain Elastography in Predicting Autoimmune Thyroiditis
title_short The Value of Strain Elastography in Predicting Autoimmune Thyroiditis
title_sort value of strain elastography in predicting autoimmune thyroiditis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7692451/
https://www.ncbi.nlm.nih.gov/pubmed/33121150
http://dx.doi.org/10.3390/diagnostics10110874
work_keys_str_mv AT cepehacristinamihaela thevalueofstrainelastographyinpredictingautoimmunethyroiditis
AT paulcorina thevalueofstrainelastographyinpredictingautoimmunethyroiditis
AT borleaandreea thevalueofstrainelastographyinpredictingautoimmunethyroiditis
AT borcanflorin thevalueofstrainelastographyinpredictingautoimmunethyroiditis
AT fofiurenata thevalueofstrainelastographyinpredictingautoimmunethyroiditis
AT deheleancristinaadriana thevalueofstrainelastographyinpredictingautoimmunethyroiditis
AT stoiandana thevalueofstrainelastographyinpredictingautoimmunethyroiditis
AT cepehacristinamihaela valueofstrainelastographyinpredictingautoimmunethyroiditis
AT paulcorina valueofstrainelastographyinpredictingautoimmunethyroiditis
AT borleaandreea valueofstrainelastographyinpredictingautoimmunethyroiditis
AT borcanflorin valueofstrainelastographyinpredictingautoimmunethyroiditis
AT fofiurenata valueofstrainelastographyinpredictingautoimmunethyroiditis
AT deheleancristinaadriana valueofstrainelastographyinpredictingautoimmunethyroiditis
AT stoiandana valueofstrainelastographyinpredictingautoimmunethyroiditis