Integrating shear wave elastography into clinical prediction of Graves' disease recurrence: a novel risk scoring system.

IF 3.9 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Frontiers in Endocrinology Pub Date : 2025-03-12 eCollection Date: 2025-01-01 DOI:10.3389/fendo.2025.1551983
Xiao-Yun Zha, Ze-Hong Xu, Jia-Jia Dong, Liang-Xiao Xie, Peng-Bin Lai, Chang-Shun Wei, Hua-Qiang Zheng, Duo-Bin Huang, Jin-Zhi Wu
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引用次数: 0

Abstract

Objective: This study aims to evaluate the utility of shear wave elastography (SWE) in predicting the recurrence risk of Graves' disease(GD), to construct a recurrence risk prediction model that integrates SWE and clinical characteristics, and to develop a risk scoring system aimed at enhancing the survival rate of patients with GD following drug treatment and prognosis management.

Methods: A prospective cohort study was conducted involving with 169 patients diagnosed with first-episode GD. By analyzing SWE parameters, three-dimensional thyroid volume, TRAb levels, and other clinical indicators, the Cox proportional hazards model was used to construct a recurrence risk prediction model for GD. Bootstrap resampling was employed to verify the model's reliability. A simple recurrence risk scoring system was also developed based on independent risk factors for clinical use.

Results: The study identified several factors significantly associated with GD recurrence: age <35 years, a family history of GD, an initial TRAb level≧15 IU/ml, a thyroid volume≧19 cm³, an initial SWE≧2.0 m/s, and a TSH(thyroid stimulating hormone) normalization duration <4 months. Notably, SWE was found to be a strong predictor, with patients exhibiting SWE ≥2.0 m/s having a recurrence risk that is 4.54 times greater than those with lower values. Based on these risk factors, a scoring system was developed with a cutoff of 4 points for recurrence risk, demonstrating a sensitivity of 74% and a specificity of 91.8%. The area under the curve (AUC) of the final model was 0.91, indicating high predictive accuracy.

Conclusions: SWE is an independent predictor of recurrence risk in GD. When combined with traditional clinical indicators, it significantly enhances the predictive capability for GD recurrence. The risk score model provides a simple and effective tool for individualized management and optimization of treatment strategies.

将剪切波弹性成像纳入Graves病复发的临床预测:一种新的风险评分系统。
目的:评价横波弹性成像(shear wave elastography, SWE)在预测Graves病(GD)复发风险中的应用价值,构建横波弹性成像与临床特征相结合的复发风险预测模型,建立风险评分系统,提高GD患者在药物治疗和预后管理后的生存率。方法:对169例首发GD患者进行前瞻性队列研究。通过分析SWE参数、三维甲状腺体积、TRAb水平等临床指标,采用Cox比例风险模型构建GD复发风险预测模型。采用自举重采样方法验证模型的可靠性。基于独立危险因素的简单复发风险评分系统也被开发出来供临床使用。结果:研究确定了几个与GD复发显著相关的因素:年龄结论:SWE是GD复发风险的独立预测因子。结合传统临床指标,可显著提高对GD复发的预测能力。风险评分模型为个体化管理和优化治疗策略提供了一种简单有效的工具。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Frontiers in Endocrinology
Frontiers in Endocrinology Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
5.70
自引率
9.60%
发文量
3023
审稿时长
14 weeks
期刊介绍: Frontiers in Endocrinology is a field journal of the "Frontiers in" journal series. In today’s world, endocrinology is becoming increasingly important as it underlies many of the challenges societies face - from obesity and diabetes to reproduction, population control and aging. Endocrinology covers a broad field from basic molecular and cellular communication through to clinical care and some of the most crucial public health issues. The journal, thus, welcomes outstanding contributions in any domain of endocrinology. Frontiers in Endocrinology publishes articles on the most outstanding discoveries across a wide research spectrum of Endocrinology. The mission of Frontiers in Endocrinology is to bring all relevant Endocrinology areas together on a single platform.
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