Otoimmün tiroid hastalıklarında tiroid sintigrafisi bulguları ile ARFİ-elastografi bulgularının karşılaştırılması
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Tarih
2016
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Otoimmün tiroid hastalıkları toplumda sık görülmekte ve çoğunlukla benzer klinik ve laboratuvar tablolarla ortaya çıkmaktadır. Otoimmün tiroid hastalıklarının tanı ve takibinde tiroid sintigrafisi sık kullanılan bir görüntüleme yöntemi olup, kantitatif değerlendirmeye de olanak sağlamaktadır. ARFI (Acoustıc radiation force impulse) elastografi ise ses dalgasının dokuda yayılım hızını göz önüne alarak doku sertliğinin kantitatif olarak ölçülebilesine olanak sağlayan yeni bir USG (ultrasonografi) modalitesidir. Bu çalışmada amacımız; tiroid bezinden elde edilen ARFI elastografik ve sintigrafik kantitatif verileri karşılaştırmak ve ARFI elastografik ölçümlerin otoimmün tiroid hastalıklarının tanısındaki diagnostik etkinliğini değerlendirmektir. Çalışmaya 24 Graves hastası, 15 Hashimoto hastası ve 22 kontrol vakası olmak üzere toplam 61 (41 kadın; 20 erkek) kişi dahil ettik. Hastaların yaş ortalaması 33.9 ± 10.9 yıl idi. Tiroid bezlerinde nodül bulunan hastalar çalışmaya dahil edilmedi. Tc 99m Perteknetat ile tiroid uptake yapıldı ve ARFI elastografi ile tiroid bezinin ortalama elastografi skoru belirlendi. Her iki hasta grubunun bulguları kontrol grubu ve birbirleri ile istatistiksel olarak karşılaştırıldı. Tiroid uptake testi için; iki hasta grubu arasında (p< 0.001) ve her iki hasta grubu ile kontrol grubu arasında (Hashimoto grubu için p< 0.001; Graves için p< 0.001) istatistiksel olarak anlamlı fark bulundu. Ancak ARFI yöntemi için; iki hasta grubu arasında (p: 0.336) ve her iki hasta grubu ile kontrol grubu arasında (Hashimoto grubu için p: 0.14, Graves için p: 0.08) istatistiksel olarak anlamlı fark bulunmadı. Tc 99m Perteknetat uptake değerleri ve ARFI değerleri arasında zayıf düzeyli korelasyon saptandı (p: 0.048, r: 0.255). Sonuç olarak, otoimmün tiroid hastalıklarının tanısında; tiroid sintigrafisi ve tiroid uptake verileri oldukça değerli olup, ARFI-elastosonografik ölçümlerin bu sintigrafik verilerin yerini alması pek mümkün gözükmemektedir. ANAHTAR SÖZCÜKLER: Tiroid sintigrafisi, Tiroid uptake, ARFİ, Graves hastalığı, Hashimoto hastalığı
Autoimmune thyroid diseases are common in the population and are often present with similar clinical and laboratory findings. Thyroid scintigraphy is an imaging technique commonly used in the diagnosis and follow of autoimmune thyroid diseases and it allows the quantitative evaluation. ARFI (Acoustic radiation force impulse ) elastography is a new ultrasound modality, which can measure and allows the quantification of tissue stiffness considering the speed of sound wave propagation in the tissue. In this study, our aim is to compare the ARFI elastographic and scintigraphic quantitative data obtained from the thyroid gland and to evaluate the diagnostic value of ARFI elastographic measurements in the autoimmune thyroid diseases. We included in the study a total of 61 patients (41 women, 20 men) including 24 Graves' disease, 15 Hashimoto disease and 22 control subjects. The mean age of patients was 33.9 ± 10.9 years. Patients with thyroid nodules were not included in the study. Thyroid uptake was performed with Tc 99m pertechnetate and the elastosonography score of the thyroid gland was determined with ARFI elastosonography. The findings of both disease groups were statistically compared with each other and the findings of the control group. For thyroid uptake test; a statistically significant difference was found between the two disease groups (p< 0.001) and between the each disease and the control group (p< 0.001 for Hashimoto group, p< 0.001 for Graves group). However, for ARFI method; a statistically significant difference was not found between the two disease groups (p: 0.336) and between each disease and the control group (p: 0.14 for Hashimoto group, p: 0.08 for Graves group). A weak correlation was found between the thyroid uptake values and ARFI scores (p: 0.048, r: 0.255). As a result, the thyroid scan and thyroid uptake measurements are extremely valuable in the diagnosis of the autoimmune thyroid diseases and ARFI elastosonographic measurements do not seem to replace the scintigraphic data. KEYWORDS: Thyroid scintigraphy, thyroid uptake, ARFI, Graves' disease, Hashimoto disease
Autoimmune thyroid diseases are common in the population and are often present with similar clinical and laboratory findings. Thyroid scintigraphy is an imaging technique commonly used in the diagnosis and follow of autoimmune thyroid diseases and it allows the quantitative evaluation. ARFI (Acoustic radiation force impulse ) elastography is a new ultrasound modality, which can measure and allows the quantification of tissue stiffness considering the speed of sound wave propagation in the tissue. In this study, our aim is to compare the ARFI elastographic and scintigraphic quantitative data obtained from the thyroid gland and to evaluate the diagnostic value of ARFI elastographic measurements in the autoimmune thyroid diseases. We included in the study a total of 61 patients (41 women, 20 men) including 24 Graves' disease, 15 Hashimoto disease and 22 control subjects. The mean age of patients was 33.9 ± 10.9 years. Patients with thyroid nodules were not included in the study. Thyroid uptake was performed with Tc 99m pertechnetate and the elastosonography score of the thyroid gland was determined with ARFI elastosonography. The findings of both disease groups were statistically compared with each other and the findings of the control group. For thyroid uptake test; a statistically significant difference was found between the two disease groups (p< 0.001) and between the each disease and the control group (p< 0.001 for Hashimoto group, p< 0.001 for Graves group). However, for ARFI method; a statistically significant difference was not found between the two disease groups (p: 0.336) and between each disease and the control group (p: 0.14 for Hashimoto group, p: 0.08 for Graves group). A weak correlation was found between the thyroid uptake values and ARFI scores (p: 0.048, r: 0.255). As a result, the thyroid scan and thyroid uptake measurements are extremely valuable in the diagnosis of the autoimmune thyroid diseases and ARFI elastosonographic measurements do not seem to replace the scintigraphic data. KEYWORDS: Thyroid scintigraphy, thyroid uptake, ARFI, Graves' disease, Hashimoto disease
Açıklama
Anahtar Kelimeler
Tiroid sintigrafisi, Thyroid scintigraphy, Tiroid uptake, Tthyroid uptake, ARFİ, ARFI, Graves hastalığı, Graves' disease, Hashimoto hastalığı, Hashimoto disease
