Elastographic pattern of Grave's disease
Jaime Fernandez Sanchez · Ultraschall in der Medizin - European Journal of Ultrasound · 2013
Purpose: Graves disease (GD) is an autoimune disorder (also known as Basedow disease or Morbus Basedow in German speaking countries) and is the most common cause of hyperthyroidism. The elastography (ELS) is a new diagnostic method that has been employed predominantly for a better differentiation of benign and malignant masses. The aim of this prospective study was to evaluate the elatographic pattern of GD. Material and methods: 52 consecutive patients with GD were enrolled in this prospective study. All patients had a latent or manifest hyperthyroidism with increased anti-thyrotropin receptor antibodies (TRAK) and with a typical thyroid ultrasound and thyroid scan. A real-time ELS using a manual free-hand compression technique was performed in all cases. The elasticity of the thyroid was evaluated by means of color appearance: red/green for elastic tissue and blue for hard tissue. Also ROI placement in the thyroid gland (TG) and surrounding soft-tissue (perithyroid soft tissue, PST) was performed and strain values such as strain ratios of PST to TG were calculated Results: Homogeneus soft elastogram (increased elasticity) in 11/52 cases (strain 0.721 ± 0.21) (elastographic pattern Grave's disease 1, – PG1), predominantly soft elastogram with small areas of reduced elasticity in 14/52 cases (strain 0.545 ± 0.09) (PG2), mixed spotty areas of normal and reduced elasticity (mixed elastogram) in 17/52 cases (strain 0.384 ± 0.04) (PG3) and predominantly hard elastogramm with small areas of normal elasticity in 10/52 cases (0.271 ± 0.11) (PG4). Conclusion: The thyroid may show a diversal elasticity in GD with four main elastographic patterns. Whereas the elastographic patterns PG1 – 2 are more frequent in patients with GD diagnosed in the preceding 12 months, patients with more than 12 months of disease duration show more frequent elastographic pattern PG3 – 4, may be due to reperative changes in GD after recurrence of hyperthyroidism.