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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...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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MDPI
2020
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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 |
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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 |
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