Evaluation of Normal Thyroid Tissue and Autoimmune Thyroiditis in Children Using Shear Wave Elastography

Objectives: Shear wave elastography (SWE) is an ultrasonographic technique that evaluates tissue elasticity and is user-independent. It is used especially in the evaluation of thyroiditis and in distinguishing malignant-benign thyroiditis from thyroid nodules in adults, but so far no studies have evaluated SWE of the thyroid in children. The aim of this study was to measure the elasticity of normal thyroid tissue in children and adolescents using SWE and to investigate the role of SWE in the diagnosis of autoimmune thyroiditis in childhood.

Methods: In total, 113 healthy children (66 girls, 47 boys) and 57 children (45 girls, 12 boys) who were being followed up for autoimmune thyroiditis were evaluated by SWE after B-mode ultrasound. The quantitative evaluation of normal thyroid tissue in healthy children and those with autoimmune thyroiditis was performed using shear wave velocity (SWV) values (m/s).

Results: The average SWV value of thyroid parenchyma in the healthy children was 1.82 ± 0.3 m/s (min: 1.32 m/s, max: 2.37 m/s). There was a significant positive correlation between age and SWV values and these values increased with age The average SWV value of thyroid parenchyma in children with autoimmune thyroiditis was 3.7±1.2 m/sn (min: 2.59 m/sn, max: 6.25 m/sn). In children with autoimmune thyroiditis, thyroid SWV values were statistically significantly higher than in healthy children (p ≤ 0.05). The cutoff value with the highest diagnostic accuracy for elasticity value was 2.39 m/s; sensitivity and specificity were 97.4, 100 respectively. There was no correlation between elasticity values and thyroid function tests with autoantibody levels (p˃ 0.05).

Conclusions: SWE is a useful imaging method that can be used with routine US in evaluation of the thyroid in children.