Multifactor Analysis of Thyroid Stiffness in Graves Disease: A Preliminary Study

Leesburg, VA, May 20, 2019—Compared with real-time elastography, shear wave elastography (SWE) has been shown to be more reproducible, operator independent, and appropriate for diffuse lesions because of the added data regarding tissue elasticity.

Although SWE has been utilized to evaluate the stiffness of thyroid nodules, few studies are available for patients with diffuse thyroid pathologic abnormalities, so Shimei Li of Sun Yat-Sen University in Guangzhou, China set out to determine the value of SWE in Graves disease and to identify possible influencing factors of thyroid stiffness.

According to an Original Research article in the American Journal of Roentgenology, 45 male and 117 female subjects (mean age, 32.7 ± 10.9 years; range, 11–67 years) were enrolled from November 2015 to February 2018, including 162 patients with Graves disease and 45 healthy volunteers with normal thyroids, matched for age and sex.

All patients underwent an SWE examination that recorded three elasticity values in kilopascals (kPa) based on the Young modulus formula for each thyroid gland.

The mean of elastic modulus values (SWE mean, SWE minimum, and SWE maximum) for patients with Graves disease measured 17.6 ± 6.4 kPa, 10.7 ± 6.4 kPa, and 25.6 ± 10.6 kPa, respectively, which were significantly higher than those for control subjects and consistent with the clinical palpation reports of other authors. 

Using SWE mean as a more comprehensive index to explore the correlation between thyroid stiffness and influencing factors associated with Graves disease, Li and team’s preliminary study also suggested that the duration of disease, thyroid size, and isthmus thickness, as well as levels of thyroid peroxidase, thyroglobulin, and thyrotropin receptor antibodies positively correlated with SWE mean in patients with the disease.


Founded in 1900, the American Roentgen Ray Society (ARRS) is the first and oldest radiology society in the North America, dedicated to the advancement of medicine through the profession of radiology and its allied sciences. An international forum for progress since the discovery of the x-ray, ARRS maintains its mission of improving health through a community committed to advancing knowledge and skills with an annual scientific meeting, monthly publication of the peer-reviewed American Journal of Roentgenology (AJR), quarterly issues of InPractice magazine, topical symposia and AJR Live Webinars, print and online educational materials, as well as awarding scholarships via The Roentgen Fund®.