Shear Wave Elastography For The Evaluation Of Graves' Disease

Objective: To evaluate the potential role of the shear wave elastography in the evaluation of thyroid parenchyma among patients with Graves' disease.Methods: We cross-sectionally enrolled 45 patients with Graves' disease and 25 healthy control participants. Thyroid parenchyma stiffness (SWE) was measured by shear wave elastography using a 9 MHz-linear probe. In all patients, 5 region-of-interests were placed in thyroid gland for each lobe and measured in kPa. Mean SWE of all subjects were calculated. Quantitative variables are shown as the mean +/- SD or median (minimum-maximum). Stiffness values of thyroid parenchyma were compared with using Mann-Whitney U test. A p-value less than 0.05 was considered as statistically significant.Results: The mean SWE of thyroid gland were found as 28,1 (min 7,15, max 69,14) kPa in Graves' disease and 10,11 (min 3,81, max 20,21) kPa in control group. Mean SWE were higher in the Graves' disease than in the control group (p<0,001). The area under the receiver operating characteristic of stiffness values in differentiating Graves' disease from normal thyroid parenchyma was 0,954(CI; 0,908-0,999). The cut-off value for SWE was 15,3 kPa. The sensitivity was 93% and specificity was 80%. SWE was negatively correlated with TSH and positively correlated with fT3 and fT4 level (r=-0.652, p<0,001, r=0.598, p<0,001 and r=0,498 p<0,001). SWE was correlated with anti-thyroid peroxidase antibody, TSH-receptor antibody, anti-thyroglobuline antibody.Conclusion: Quantitative stiffness value measured by shear wave elastography was significantly higher in Graves' disease than in normal thyroid parenchyma and may be promising tool in the prediction of the presence of Graves' disease.