The value of strain ratio in differential diagnosis of thyroid solid nodules

Objective: Pretibial edema (PTO) is a common examination finding in patients with both heart failure (HF) and nephrotic syndrome (NS). We aimed to evaluate the utility of PTO strain ratio (PTO-SR) obtained by strain elastography (SE) in the diagnosis of HF and NS. Materials and Methods: A total of 80 patients (40 patients with HF and 40 patients with NS) were included in this study. Physical examination echocardiography and laboratory examinations were performed. PTO elastographic color grade and PTO-SR measurements were performed in the PTO region by SE. Results: PTO-SR and presence of PTO elastographic color grade-I were found to be higher in HF. Tricuspid regurgitation pressure gradient (TRPG), left ventricular (LV) diameters and volumes were significantly higher and LV ejection fraction (EF) was significantly lower in HF. LVEF and PTO-SR independently determined the presence of HF. The each-0.1 increase in PTO-SR was being to the risk of HF by 29.1%. In predicting the presence of HF, the area under the ROC curve was 0.827 for PTO-SR. The cut-off value for PTO-SR was taken as 0.70, it was determined the patients with HF disease with 80.0% sensitivity and 76.5% specificity. PTO-SR value was found to be closely related to TRPG, LVEF, and LV volumes. A close relationship was found between PTO-SR and TRPG. Conclusion: In patients with HF, the PTO-SR obtained by SE is higher than in patients with NS and can be used as an objective parameter for HF differential diagnosis in addition to conventional HF diagnostic methods.

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Intrathyroidal Ectopic Thymus and Sonoelastographic Findings

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405617666210329095227 ◽

2021 ◽

Vol 17 ◽

Author(s):

Serkan Guneylı ◽

Murat Serhat Aygun ◽

Orhun Cig Taskın ◽

Ergin Sagtas ◽

Bulent Colakoglu

Keyword(s):

Differential Diagnosis ◽

Pediatric Population ◽

Posterior Part ◽

Strain Ratio ◽

Ectopic Thymus ◽

Strain Elastography ◽

Common Location ◽

Asymptomatic Patients ◽

Available Information

Background: Intrathyroidal ectopic thymus (IET) can be misdiagnosed as thyroid nodules. Purpose: To evaluate the sonoelastographic findings of IET in pediatric population. Methods: Twelve children who had been examined with ultrasound (US) and strain elastography between December 2012 and December 2019 were included in this retrospective study. The patients’ demographics and ultrasonographic findings including the location, margin, shape, diameters, volume, structure, vascularity, and elastography values of the lesions were evaluated. Results: Twelve lesions were detected in 12 asymptomatic patients (3 females and 9 males) with a mean age of 4.67 ± 2.27 years. The most common location of the IET was in posterior part and middle third of thyroid, and the most common appearance on US was a well-defined, ovoid-shaped, and predominantly hypoechoic solid lesion with punctate/linear branching hyperechogenities. The lesions were mostly hypovascular on Doppler US. The mean strain ratio on elastography was found to be 1.10 ± 0.04. In the follow-up of 7 patients with available information, there was not any significant change in size or appearance of IET on US. Conclusion: IET should be considered in the differential diagnosis of the lesions within the thyroid. The first step to accurately diagnose an IET is to consider it in the differential diagnosis. In addition to US, strain elastography findings can be used to distinguish IETs from papillary thyroid cancers which can have similar US appearance, and help avoid unnecessary biopsies.

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