Value of the New Elastography Technique using Acoustic Radiation Force Impulse in Differentiation between Hashimoto’s Thyroiditis and Graves’ Disease

Abstract

Background and Aim: This study was performed to evaluate the role and accuracy of shear wave elastography in the differentiation between Graves’ disease (GD) and Hashimoto’s thyroiditis (HT), in comparison with the B-mode ultrasound and color Doppler ultrasound. Materials and Methods: This study was non-randomized prospective study. The study included 30 patients with GD, 65 patients with HT, and 35 patients with normal thyroid glands. Assessment of ultrasonographic criteria, color Doppler flow pattern, and shear patterns differed significantly between the control group and the group of diffuse thyroid disease (P < 0.001). The most specific sign for diagnosing HT was nodularity (97.87%), and the most sensitive sign was coarse echotexture (81.54%). Color Doppler flow (CDF) showed sensitivity of 91.8%, specificity of 56.92%, positive predictive value of 52.54%, negative predictive value of 92.5%, and diagnostic accuracy of 68.69% in the differentiation between GD and HT. The mean shear wave velocity (SWV) was 2.61 ± 0.32 m/s in the GD group (range: 2.1–3.21 m/s), 2.85 ± 0.52 m/s in the HT group (range: 2.31–3.82 m/s), and 1.75 ± 0.37 m/s in the control group (range: 1.24–2.36 m/s). The mean SWVs in the GD and HT groups were significantly higher than that in the control group (P < 0.001). The mean SWV in the HT group was higher than that in the GD group (P = 0.03). Conclusion: Quantitative and qualitative SWE is useful for diagnosing diffuse thyroid disease and evaluating the degree of fibrosis in autoimmune thyroiditis. However, acoustic radiation force impulse techniques cannot differentiate between HT and GD reliably.