Single article

DOI: 10.47026/2413-4864-2022-3-36-46

Pykov M.I., Kuzmina N.E., Rostovtsev N.M.

Thyroid Elastography in Children

Keywords: ultrasound diagnostics, shear wave elastography, thyroid gland, children

The aim of the research was to study the stiffness of an unchanged thyroid gland using shear wave elastography with elastometry in children in different gender and age groups. 175 children with normal hormonal status aged from 3 to 17 were examined, 80 of them were girls and 95 boys. All children underwent ultrasound examination of the thyroid gland in the "supine" position of the examinees, supplemented by two-dimensional shear wave elastography on Aixplorer apparatus (Supersonic Imagine, France) using a linear sensor in the frequency range of 5-18 MHz. Five measurements of Young's modulus value of the right and left lobes of the thyroid gland were carried out. Using Multi Q-box software, the following values of Young's modulus (E) for each fraction were automatically determined: the mean (Emean), the maximum (Emax), the minimum (Emin), the standard deviation (SD). The study established a statistically significant increase in thyroid stiffness values in children with increasing age, statistically significant differences in the stiffness of thyroid right and left lobes (p = 0.003), the absence of gender differences in thyroid stiffness (median Emean in boys – 7.40 kPa, in girls – 6.80 kPa; p = 0.170). The technique of shear wave elastography that is offered by the authors can become an additional diagnostic tool in assessing the condition of the thyroid gland in children. The established values of thyroid tissue stiffness in children of different age groups can be recommended to be used for the purpose of timely diagnosis of thyroid pathology.

References

  1. Borsukov A. Comments and discussion on the thyroid gland elastography World Recommendations 2015. Endocrine Surgery, 2017, vol. 11, pp. 61–69. DOI: 10.14341/serg2017261-69.
  2. Delyagin V.M., Feoktistova E.V., Izotova O.Yu., Urazbagambetov A. Primenenie ARFI-elastografii dlya otsenki zhestkosti parenkhimy shchitovidnoi zhelezy u detei, podrostkov i molodykh vzroslykh [Application ARFI-elastography to Assess Stiffness Thyroid Parenchyma in Children, Adolescents and Young Adults]. Meditsinskaya vizualizatsiya, 2014, no. 5, pp. 130–133.
  3. Kasatkina E.P. Aktual’nye problemy tireoidologii: profilaktika ioddefitsitnykh zabolevanii [Actual problems of thyroidology: prevention of iodine deficiency diseases]. Problemy Endokrinologii, 2006, vol. 52(6), pp. 30–33. DOI: https://doi.org/10.14341/probl200652630-33.
  4. Mazurin A.V., Vorontsov M.I. Propedevtika detskikh boleznei [Propaedeutics of childhood diseases]. Moscow, Meditsina Publ., 1985, 432 p.
  5. Mit’kov V.V., Mit’kova M.D. Ul’trazvukovaya elastografiya sdvigovoi volnoi [Ultrasonic shear wave elastography]. Ul’trazvukovaya i funktsional’naya diagnostika, 2015, vol. 2, pp. 94–108.
  6. Pykov M.I., Kuz’mina N.E., Kinzerskii A.Yu. Izuchenie normal’nykh pokazatelei zhestkosti pecheni u detei s ispol’zovaniem metoda elastometrii sdvigovoi volnoi [Study of normal liver stiffness in children using the shear wave elastometry method]. Zhurnal imeni G.N. Speranskogo, 2017, no. 4, pp. 63–69.
  7. Andersen S.B., Ewertsen C., Carlsen J.F., Henriksen B.M., Nielsen M.B. Ultrasound Elastography is Useful for Evaluation of Liver Fibrosis in Children-A Systematic Review. J Pediatr Gastroenterol Nutr., 2016, vol. 63(4), pp. 389–399. DOI: https://doi.org/10.1097/MPG.0000000000001171.
  8. Bakırtaş Palabıyık F., İnci E., Papatya Çakır E.D., Hocaoğlu E. Evaluation of Normal Thyroid Tissue and Autoimmune Thyroiditis in Children Using Shear Wave Elastography. Journal of clinical research in pediatric endocrinology, 2019, vol. 11(2), pp. 132–139. DOI: https://doi.org/10.4274/jcrpe.galenos.2018.2018.0137.
  9. Bamber J., Cosgrove D., Dietrich C.F., Fromageau J. et al. Efsumb guidelines and recommendations on the clinical use of ultrasound elastography. Part 1: Basic principles and technology. Ultraschall Med., 2013, vol. 34, pp. 169–184. DOI: https://doi.org/10.1055/s-0033-1335205.
  10. Cantisani V., Lodise P., Grazhdani H., Mancuso E. et al. Ultrasound elastography in the evaluation of thyroid pathology. Current status, J. Radiol., 2014, vol. 83(3), pp. 420–428. DOI: https://doi.org/10.1016/j.ejrad.2013.05.008.
  11. Cepeha C.M., Paul C., Borlea A., Fofiu R. et al. Shear-Wave Elastography – Diagnostic Value in Children with Chronic Autoimmune Thyroiditis. Diagnostics (Basel), 2021, vol. 11, p. 248. DOI: 10.3390/diagnostics11020248.
  12. Cosgrove D., Barr R., Bojunga J. et al. WFUMB Guidelines and Recommendations on the Clinical Use of Ultrasound Elastography: Part 4. Thyroid. Ultrasound Med Biol., 2017, vol. 43(1), pp. 4–26. DOI: 10.1016/j.ultrasmedbio.2016.06.022.
  13. Cosgrove D., Piscaglia F., Bamber J., Bojunga J. et al. EFSUMB guidelines and recommendations on the clinical use of ultrasound elastography. Part 2: Clinical applications. Ultraschall Med., 2013, vol. 34, pp 238–253. DOI: https://doi.org/10.1055/s-0033-1335375.
  14. Dietrich C.F., Bamber J., Berzigotti A., Bota S. et al. EFSUMB guidelines and recommendations on the clinical use of liver ultrasound elastography, update 2017 (long version). Ultraschall Med., 2017, vol. 38, e16–e47. DOI: https://doi.org/10.1055/s-0043-103952.
  15. Dietrich C.F., Bamber J., Berzigotti A., Bota S. et al. EFSUMB guidelines and recommendations on the clinical use of liver ultrasound elastography, update 2017 (short version). Ultraschall Med., 2017, vol. 38, pp. 377–394. DOI: https://doi.org/10.1055/s-0043-103955.
  16. Dietrich C.F., Sirli R., Ferraioli G., Popescu A. et al. Current Knowledge in Ultrasound-Based Liver Elastography of Pediatric Patients. Sci., 2018, vol. 8, p. 944. DOI: https://doi.org/10.3390/app8060944.
  17. Dietrich C.F., Ferraioli G., Sirli R., Popescu A. et al. General advice in ultrasound based elastography of pediatric patients. Med Ultrason., 2019, vol. 21(3), pp. 315–326. DOI: https://doi.org/10.11152/mu-2063.
  18. Kandemirli S.G., Bayramoglu Z., Caliskan E. et al.Quantitative assessment of thyroid gland elasticity with shear-wave elastography in pediatric patients with Hashimoto’s thyroiditis. J Med Ultrasonics, 2018, vol. 45, pp. 417–423. DOI: https://doi.org/10.1007/s10396-018-0859-0.
  19. Mohammed Hazem, Ibrahim Khalid Al Jabr, Abdulwahab A. AlYahya, Ahmed Gaber Hassanein, Hisham A. Elghany Algahlan. Reliability of shear wave elastography in the evaluation of diffuse thyroid diseases in children and adolescents. European Journal of Radiology, 2021, vol. 143, 109942. DOI: https://doi.org/10.1016/j.ejrad.2021.109942.
  20. Pawluś A., Sokołowska-Dąbek D., Szymańska K., Inglot M.S., Zaleska-Dorobisz U. Ultrasound Elastography – Review of Techniques and Its Clinical Applications in Pediatrics – Part 1. Adv Clin Exp Med., 2015, vol. 24(3), pp. 537–543. DOI: https://pubmed.ncbi.nlm.nih.gov/26467146.
  21. Perez-Montiel M.D., Suster S. The spectrum of histologic changes in thyroid hyperplasia: a clinicopathologic study of 300 cases. Hum. Pathol., 2008, vol. 39, no. 7, pp. 1080–1087. DOI: https://pubmed.ncbi.nlm.nih.gov/18495207.
  22. Pykov M., Kuzmina N., Rostovtsev N., Kinzersky A. Elastometry Indices of Unchanged Liver in Healthy Children. In: Ultrasound Elastography. London, United Kingdom, IntechOpen, 2019 [Online]. Available at: https://www.intechopen.com/chapters/68142. DOI: 10.5772/intechopen.88004.
  23. Shiina T., Nightingale K.R., Palmeri M.L., Hall T.J. et al. Wfumb guidelines and recommendations for clinical use of ultrasound elastography: Part 1: Basic principles and terminology. Ultrasound Med. Biol., 2015, vol. 41, pp. 1126–1147.
  24. Sporea I., Sirli R., Bota S et al. ARFI elastography for the evaluation of diffuse thyroid gland pathology: Preliminary results. World J. Radiol., 2012, vol. 28, no. 4, pp. 174–178.
  25. Uysal E., Öztürk M. Quantitative Assessment of Thyroid Glands in Healthy Children with Shear Wave Elastography. Ultrasound Q., 2019, vol. 35, pp. 297–300.
  26. Zaleska-Dorobisz U., Pawluś A., Szymańska K., Łasecki M., Ziajkiewicz M. Ultrasound Elastography – Review of Techniques and Its Clinical Applications in Pediatrics – Part 2. Adv Clin Exp Med., 2015, vol. 24(4), pp. 725–730. DOI: https://doi.org/10.17219/acem/34581.

About authors

Pykov Mikhail I.
Doctor of Medical Sciences, Professor, Head of the Department of Pediatric Radiology, Russian Medical Academy of Postgraduate Education, Russia, Moscow (pykov@yandex.ru; ORCID: https://orcid.org/0000-0003-3731-6263)
Kuzmina Natalia E.
Candidate of Medical Sciences, Doctor of Radiation Diagnostics, Chelyabinsk Regional Children Clinical Hospital, Russia, Chelyabinsk (k-natalya@inbox.ru; )
Rostovtsev Nikolay M.
Candidate of Medical Sciences, Associate Professor, Department of General and Pediatric Surgery, South Ural State Medical University; Deputy Chief Physician for Surgery, Chelyabinsk Regional Children Clinical Hospital, Russia, Chelyabinsk (rostovcevnm@mail.ru; )

Article link

Pykov M.I., Kuzmina N.E., Rostovtsev N.M. Thyroid Elastography in Children [Electronic resource] // Acta medica Eurasica. – 2022. – №3. P. 36-46. – URL: https://acta-medica-eurasica.ru/en/single/2022/3/5/. DOI: 10.47026/2413-4864-2022-3-36-46.