Author(s)

Düzgün Yıldırım¹, Deniz Esin Tekcan Şanlı^2*, Deniz Aliş³, Mutlu Şahin⁴, Alev Bakır⁵, Ahmet Erdem Kılavuz⁶

¹Department of Medical Imaging, Vocational School of Health Sciences, Acibadem University, Istanbul, Turkey.
²Department of Radiology, Acibadem Kozyatagi Hospital, Istanbul, Turkey.
³Department of Radiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Research and Training Hospital, Istanbul, Turkey.
⁴Department of General Surgery, Dişkapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey.
⁵Biostatistics and Medical Informatics Department, Haliç University, Istanbul, Turkey.
⁶Department of Otorhinolaryngology, Acibadem University, Istanbul, Turkey.

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 (Δv) 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 Δv values were taken into account. In summary, the effects of chronic autoimmune thyroiditis can be distinguished by simply using Δv on virtual touch tissue imaging quantification maps. When the cut-off value of Δv 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.

ARFI, Hashimoto Thyroiditis, SWE, SWV, VTIQ

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.