SHEAR WAVE ELASTOGRAPHY OF SALIVARY AND THYROID GLANDS IN PEDIATRIC PATIENTS WITH FMF AND AMYLOIDOSIS

Abstract

Objective: The aim of this study is to investigate the effects of recurrent inflammation and amyloid deposition on salivary and thyroid gland elasticity in pediatric patients with Familial Mediterranean Fever (FMF) using shear wave ultrasound elastography. Material and Method: This study included 31 patients with a diagnosis of FMF. At the time of imaging, 22 patients were admitted to the rheumatology department with an acute attack (45% girls, mean age±SD: 13.3±4.6 years). The remaining nine patients had histopathologically proven amyloidosis (50% girls, mean age±SD: 17.4±7.1 years). The control group comprised 40 healthy children (50% girls; mean age: 11.6±4.6 years). Shear wave elastography (SWE) measurements of the bilateral parotid, submandibular and thyroid glands were performed. Results: The median shear wave elasticity and velocity values of the salivary and thyroid glands in FMF patients imaged during an acute attack and patients with amyloidosis were significantly higher compared to the normal control subjects. However, the elastography values between FMF patients imaged during acute attack and patients with amyloidosis were not significantly different. The cut–off values for differentiation of patients with FMF from control subjects were 9.1 kPa, 9 kPa and 9.9 kPa for parotid, submandibular and thyroid glands, respectively. There were moderate negative correlations between thyroid (r=-0.6, p=0.008) and parotid gland (r=-0.4; p=0.04) elasticity with C-reactive protein and between serum amyloid A with thyroid gland elasticity (r=-0.58, p=0.018). Conclusion: Both acute inflammation and amyloid deposition would contribute to increased tissue stiffness. SWE might reflect clinically occult changes in salivary and thyroid glands that could not be demonstrated by routine gray scale ultrasonography in patients with FMF.

Keywords

• Children,shear wave elastography,amyloidosis

FMF VE AMİLOİDOZ TANISI ALAN PEDİATRİK HASTALARDA TÜKÜRÜK VE TiROiD BEZLERiNDE SHEAR WAVE ELASTOGRAFi DEĞERLENDiRME

Abstract

Amaç: Bu çalışmanın amacı, Ailevi Akdeniz Ateşi (FMF) tanısı olan çocuk hastalarda tekrarlayan inflamasyon ve amiloid birikiminin tükrük ve tiroid bezi doku sertliği üzerindeki etkilerini araştırmaktır. Gereç ve Yöntem: Bu çalışma FMF tanısı almış 31 hastayı içermekteydi. Görüntüleme sırasında, 22 FMF hastası akut atak ile romatoloji kliniğine yatırıldı (%45 kız, yaş ort.±SS: 13,3±4,6 yıl). Kalan 9 hasta histopatolojik olarak amiloidoz tanısı almıştı (%50 kız, yaş ort.±SS: 17,4±7,1 yıl). Kontrol grubu 40 sağlıklı çocuk (%50 kız; ort. yaş: 11,6±4,6 yıl) içermekteydi. Her iki parotis, submandibular ve tiroid bezlerine shear wave elastografi ile değerlendirme yapıldı. Bulgular: Akut atak sırasında görüntülenen FMF hastalarında ve amiloidoz hastalarında tükürük ve tiroid bezlerinin ortanca shear wave elastikiyet ve hız değerleri normal kontrol grubuna göre anlamlı derecede yüksek bulundu.Elastografi değerleri akut atak ve amiloidoz grubu arasında istatistiksel olarak anlamlı farklılık oluşturmamaktaydı. Kontrol grubu ile FMF’li hastalar arasındaki eşik değerleri parotis, submandibular ve tiroid bezleri için sırasıyla 9,1 kPa, 9 kPa ve 9,9 kPa idi. Tiroid (r=-0,6, p=0,008) ve parotis bezi (r=-0,4; p=0,04) esneklik değerleri ile C-reaktif protein arasında , ve serum amiloid A ile tiroid bezi esnekliği (r=-0,58, p=0,018) arasında orta dereceli negatif korelasyon mevcuttu. Sonuç: Hem akut enflamasyon hem de amiloid birikimi, doku sertliğinin artmasına katkıda bulunabilir. SWE FMF’li hastalarda tükürük ve tiroid bezlerinde rutin gri skala ultrasonografi ile gösterilemeyen ve kliniğe henüz yansımamış değişiklikleri ortaya çıkarabilir.

Keywords

• Çocuk,shear wave elastografi,amiloidoz

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