Ultrasonographic Shear Wave Elastography of the Thyroid in Patients with Sickle Cell Anemia

Background: Although thyroid radiology has been conducted in patients with sickle cell anemia (SCA), to our knowledge, there is no report of thyroid gland assessment using ultrasonographic shear wave elastography (US-SWE).

Objectives: To determine values for ultrasonographic US-SWE of the thyroid in patients with SCA and correlations between thyroid elasticity and biochemical variables used to evaluate thyroid function.

Methods: Prospective case-control observational study of 36 patients with SCA and 33 healthy volunteer controls. US-SWE measurements of thyroid gland parenchyma and biochemical parameters of the participants were obtained and compared, and the diagnostic accuracy of elasticity was determined.

Results: The thyroid volume was smaller in patients with SCA than that in controls ( = 0.001). Compared with the controls, the patients with SCA had significantly lower serum levels of free triiodothyronine (fT3) ( = 0.004) and thyroglobulin (Tg) ( = 0.001) and significantly higher levels of thyroid-stimulating hormone ( = 0.028). Thyroid stiffness was significantly higher in the left lobe (LL) of the patients with SCA than in the controls ( = 0.003). In the patients with SCA, we found a significant correlation between right lobe (RL) and LL stiffness and serum levels of Tg (RL [ = -0.439] and LL [ = -0.484]; = 0.021) and fT3 (RL [ = -0.463] and LL [ = -0.386]; = 0.012). Receiver operating characteristic (ROC) curve analysis of thyroid elasticity that represented a diagnosis of SCA found a cutoff of >7.31 kPa, a sensitivity of 52.0%, and a specificity of 72.0% for the RL ( = 0.316, area under the curve [AUC] 0.570), and a cutoff of >8.06 kPa, a sensitivity of 58.0%, and a specificity of 84.0% for the LL ( = 0.011, AUC 0.680).

Conclusions: US-SWE can be used to follow up thyroid changes in patients with SCA.