Ultrasound, colored Doppler and shear wave elastography in evaluation of autoimmune thyroiditis

Background The autoimmune thyroid diseases consists of two main clinical presentations: Graves' disease and Hashimoto's thyroiditis. in the absence of classic triad of Graves' disease including goiter, ophthalmopathy, and dermopathy, differentiating Graves' disease from thyroiditis can be clinically difficult. Thyroid ultrasound with gray-scale and color Doppler are the most helpful imaging modalities to differentiate normal thyroid parenchyma from diffuse thyroid disease. Also, SWE is a promising non-invasive technique in assessment of gland stiffness. Methods We studied 48 patients with autoimmune thyroid disease consists of 47 females and 1 male along with 48 healthy control group, with a mean age 35.7 +/- 9.2 years (20-53 years). All of our patients and control individual underwent conventional ultrasound, color Doppler, SWE examinations and the obtained results were correlated with clinical and laboratory findings. Results The results showed the good evaluating ability of gray-scale ultrasound (regarding echogenicity and total gland volume), Doppler examination (Superior and inferior thyroid arteries showed statistically significant higher peak systolic velocity and end diastolic velocity (PSV, EDV) in cases compared to controls with p values < 0.05) in the assessment of patients with autoimmune thyroid diseases as well as in the differentiation between chronic thyroiditis and Graves' disease. Moreover, we found that applied shear wave elastography of the whole gland can also significantly predict autoimmune thyroiditis with sensitivity 81.3% and specificity 94%. Conclusion Gray-scale ultrasound, Doppler parameters as well as elastography had a significant diagnostic value in detection and evaluation of autoimmune thyroid diseases.