Elastografía tiroidea en pacientes en edad pediátrica

Abstract

Elastosonography is an imaging modality that provides information on the elasticity of the thyroid parenchyma and can be a support tool in the diagnosis of diseases that diffusely affect the thyroid gland in undiagnosed patients. There are few thyroid elastosonography studies in children and adolescents and often with contradictory results. In this thesis, a prospective observational study has been carried out, with a descriptive and analytical purpose, in the pediatric radiology section of the Virgen de la Arrixaca University Clinical Hospital from September 2019 to February 2021. A total of 194 patients were included, of which 50 showed thyroid analytical alterations. The primary objectives were to evaluate differences in the thyroid shear wave velocity (SWV) of healthy subjects and in patients with diseases that diffusely affect the gland, to define statistically significant differences between the SWV of the left thyroid lobe (LTL) and the right thyroid lobe (RTL) and to know the normal parameters of SWV in the thyroid gland of healthy pediatric patients and possible variations with age. The secondary objectives were to evaluate if variables such as sex, height, weight, thyroid volume and the depth of the measurements can modify the values of SWV; to study the possible relationship between the presence of antithyroid and antiperoxidase antibodies with variations in SWV, to establish if there are differences in SWV depending on the number of measurements obtained (6 compared to 10), and finally to evaluate if anomalies in the echostructure of the thyroid gland can condition variations in SWV. There are significant differences between obtaining 6 or 10 measurements of SWV in the thyroid parenchyma, so it is not advisable to reduce the number of SWV measurements. Differences were found in SWV between healthy patients and sick patients, being those differences greater in the sick ones. Differenties were also found between thyroid lobes. Higher SWV are associated with older subjects, greater weight and height, and patients with the presence of antiperoxidase and antithyroglobulin antibodies. Thyroid volume is a variable dependent on SWV, especially in patients with diseases that affect the thyroid glands diffusely. Patients with a heterogeneous echostructure of the thyroid gland showed higher SWV than those with a homogeneous echostructure.