Elastography helps detect autoimmune thyroid diseases in children

 

By Amerigo Allegretto, AuntMinnie.com staff writer

December 13, 2022

Although the study findings are promising for identifying autoimmune thyroid diseases in children, authors Dr. Eda Celebi Bitkin and Dr. Nursen Toprak from Van Yüzüncü Yıl University wrote, although they noted that elastography by itself is not enough to differentiate between the two diseases.

"If the clinical aspect is poor or thyroid-stimulating hormone receptor antibodies are missing, the combined use of conventional ultrasound and acoustic radiation force impulse may be helpful in distinguishing between the two diseases," the authors wrote.

Hashimoto's thyroiditis and Graves' disease are autoimmune diseases that affect the thyroid gland. Ultrasound findings and autoantibody elevation are typically used to diagnose either disease. In rare cases, ultrasound findings may be normal in both diseases, but previous research has suggested that shear-wave velocity values from elastography are higher in autoimmune thyroiditis than in healthy thyroid glands.

Bitkin and Toprak explored the use of elastography in 88 pediatric patients with Hashimoto's thyroiditis and Graves' disease. Out of these, 28 had Hashimoto's thyroiditis, 20 had Graves' disease, and the remaining 40 were healthy controls. All patients underwent thyroid elastography and ultrasound.

The duo found that shear-wave velocity values of patients with either disease showed higher thyroid tissue stiffness than healthy controls, but when such values were compared between both diseases, the team found no significant difference (p = 0.73). As for conventional ultrasound, patients with Hashimoto's thyroiditis had a hypoechoic echo pattern similar to those with Graves' disease (p < 0.05).

"These ultrasound imaging findings reflect longer-term inflammation and may not be found in the early stages of thyroiditis," Bitkin and Toprak wrote.

The researchers did not track disease stage in their study but suggested that the degree of tissue stiffness may change as the diseases progress. They called for future studies to consider disease staging, especially for patients with Hashimoto's thyroiditis.

FATTY LIVER DISEASE AREA

 Abstract

Liver steatosis is a chronic liver disease that is becoming one of the most important global health problems, due to its direct connection with metabolic syndrome, its significant impact on patients’ socioeconomic status and frailty, and the occurrence of advanced chronic liver disease. In recent years, there has been rapid technological progress in the ultrasound-based diagnostics field that can help us to quantitatively assess liver steatosis, including continuous attenuation parameters in A and B ultrasound modes, backscatter coefficients (e.g., speed of sound) and ultrasound envelope statistic parametric imaging. The methods used in this field are widely available, have favorable time and financial profiles, and are well accepted by patients. Less is known about their reliability in defining the presence and degree of liver steatosis. Numerous study reports have shown the methods’ favorable negative and positive predictive values in comparison with reference investigations (liver biopsy and MRI). Important research has also evaluated the role of these methods in diagnosing and monitoring non-alcoholic fatty liver disease (NAFLD). Since NAFLD is becoming the dominant global cause of liver cirrhosis, and due to the close but complex interplay of liver steatosis with the coexistence of liver fibrosis, knowledge regarding NAFLD’s influence on the progression of liver fibrosis is of crucial importance. Study findings, therefore, indicate the possibility of using these same diagnostic methods to evaluate the impact of NAFLD on the patient’s liver fibrosis progression risk, metabolic risk factors, cardiovascular complications, and the occurrence of hepatocellular carcinoma. The mentioned areas are particularly important in light of the fact that most of the known chronic liver disease etiologies are increasingly intertwined with the simultaneous presence of NAFLD.

Keywords: 

ultrasound; attenuation; predictive value; liver steatosis; non-alcoholic fatty liver disease; metabolic syndrome