ARFI-Elastography: Clinical Applications in Diffuse or Nodular Thyroid Disease in Children and Adolescents

Abstract

Elastography is a new step in diagnostic medicine. This technique makes it possible to measure stiffness of the thyroid gland. Methods: In our study we conducted a cohort study of 141 children and adolescents aged 4-18 years with a suspected or known thyroid disease. Using a Siemens Acuson S3000 we examined thyroid glands both in longitudinal and cross-section. Results: With increasing tissue changes in the B-Mode of the sonography, the ARFI Velocity increases. This resulted in the average speed of 1.61 +/- 0.36 m/s, however the results of the longitudinal measuring sections proved to be more reliable. It showed a difference between the left and the right lobe, which was particularly noticeable in the cross section measurement. With the increase of vascularization, the ARFI values were initially decreasing and ultimately increasing when vascularization was extreme. A reliable Assessment of clinical presentations using elastography is not possible. The volume of the thyroid gland, TSH, fT4 and sociodemographic factors such as gender, age, weight, height and BMI did not influence the ARFI values. Conclusion: The ARFI elastography offers a wide range of gain in knowledge in the diagnostics of thyroid gland diseases in children and adolescents. Inflammation, dysfunction and structural diseases of the thyroid gland result in an increase of the ARFI values. During the examination, the examiner should pay attention the surrounding structures and its vascularization. Furthermore, the longitudinally position of the transductor should be carefully selected.