Is Strain Elastography Useful in Diagnosing Chronic Autoimmune Thyroiditis in Children?

Strain elastography (SE) determines the level of tissue stiffness and thus helps in the diagnosis and differentiation of various pathologies. This paper aims to study the elastographic differences between healthy thyroid parenchyma and ones affected by chronic autoimmune thyroiditis (CAT) in children. We included in our study 52 children diagnosed with CAT and 22 children with no thyroid pathology. After clinic examination and biological tests, an ultrasound was performed followed by SE using a Hitachi Preirus machine with a 5-15 multi-frequency linear probe. The mean strain ratio (SR) values were significantly lower in the control group compared with the CAT group (0.68 +/- 0.2 vs. 1.19 +/- 0.25; p < 0.0001). A mean value above 0.9 was found predictive for CAT with 84.62% Sensitivity(Se), 95.45% Specificity (Sp), 97.8% Positive Predictive Value (PPV), 72.4% Negative Predictive Value (NPV), and area under receiver operating characteristic (AUROC), 0.9. No differences were found between the two thyroid lobes. Also, we found no differences between girls and boys. Out of the 52 children with CAT, 39 were on therapy with levothyroxine. No differences were found between SR values in preexisting hypothyroid cases compared to euthyroid cases (1.24 +/- 0.26 vs. 1.18 +/- 0.25; p = 0.4615). Our results show that SE is a useful examination technique of children diagnosed with CAT, in accordance with other studies conducted on adults. This study lays the foundation for elastographic examination among children.

Automated summary

This study examined the elastographic differences between healthy thyroid parenchyma and those affected by chronic autoimmune thyroiditis (CAT) in children. The findings suggest that strain elastography can be used as a useful examination technique for diagnosing CAT in children, with good sensitivity and specificity.