title: ARFI elastography for the evaluation of diffuse thyroid gland pathology: Preliminary results.
abstract: OBJECTIVE
  To assess whether acoustic radiation force impulse (ARFI) elastography can differentiate normal from pathological thyroid parenchyma.
  
  
  METHODS
  We evaluated 136 subjects (mean age 45.8 ± 15.6 years, 106 women and 30 men): 44 (32.3%) without thyroid pathology, 48 (35.3%) with Basedow-Graves' disease (GD), 37 (27.2%) with chronic autoimmune thyroiditis (CAT; diagnosed by specific tests), 4 (2.9%) with diffuse thyroid goiter and 3 (2.2%) cases with thyroid pathology induced by amiodarone. In all patients, 10 elastographic measurements were made in the right thyroid lobe and 10 in the left thyroid lobe, using a 1-4.5 MHZ convex probe and a 4-9 MHz linear probe, respectively. Median values were calculated for thyroid stiffness and expressed in meters/second (m/s).
  
  
  RESULTS
  Thyroid stiffness (TS) assessed by means of ARFI in healthy subjects (2 ± 0.40 m/s) was significantly lower than in GD (2.67 ± 0.53 m/s) (P < 0.0001) and CAT patients (2.43 ± 0.58 m/s) (P = 0.0002), but the differences were not significant between GD vs CAT patients (P = 0.053). The optimal cut-off value for the prediction of diffuse thyroid pathology was 2.36 m/s. For this cut-off value, TS had 62.5% sensitivity, 79.5% specificity, 87.6% predictive positive value, 55.5% negative predictive value and 72.7% accuracy for the presence of diffuse thyroid gland pathology (AUROC = 0.804). There were no significant differences between the TS values obtained with linear vs convex probes and when 5 vs 10 measurements were taken in each lobe (median values).
  
  
  CONCLUSIONS
  ARFI seems to be a useful method for the assessment of diffuse thyroid gland pathology.
authors.affiliation: Ioan Sporea, Roxana Sirli, Simona Bota, Alina Popescu, Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy Timisoara, 300736 Timisoara, Romania.
authors.forename: Ioan
authors.initials: I
authors.lastname: Sporea
authors.forename: Roxana
authors.initials: R
authors.lastname: Sirli
authors.forename: Simona
authors.initials: S
authors.lastname: Bota
authors.forename: Mihaela
authors.initials: M
authors.lastname: Vlad
authors.forename: Alina
authors.initials: A
authors.lastname: Popescu
authors.forename: Ioana
authors.initials: I
authors.lastname: Zosin