Document Detail


Role of thyroid Doppler in differential diagnosis of thyrotoxicosis.
MedLine Citation:
PMID:  19211390     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the role of thyroid blood flow assessment by color-flow Doppler ultrasonography in the differential diagnosis of thyrotoxicosis. METHODS: Consecutive patients with thyrotoxicosis presenting to our center between June 2007 and March 2008 were included in the study. Clinical data were collected, and thyroid function tests including measurements of thyrotropin, total thyroxine, and total triiodothyronine were performed. Thyroid glands of all patients were evaluated with color-flow Doppler ultrasonography for size, vascularity, and peak systolic velocity of the inferior thyroid artery. Technetium Tc 99m pertechnetate scan was done when the diagnosis was not clear on the basis of clinical findings. Patients were divided into 2 groups for analysis: patients with destructive thyrotoxicosis and patients with Graves disease. Paired t tests and Fisher exact tests were used for statistical analysis. RESULTS: A total of 65 patients participated in the study; 31 had destructive thyrotoxicosis and 34 had Graves disease. Thyroid blood flow, as assessed by peak systolic velocity of the inferior thyroid artery, was significantly higher in patients with Graves disease than in patients with destructive thyroiditis (57.6 +/- 13.1 cm/s vs 22.4 +/- 5.4 cm/s; P<.05). All patients with destructive thyroiditis had low peak systolic velocity of the inferior thyroid artery, and 32 of 34 patients with Graves disease had high peak systolic velocity. Color-flow Doppler ultrasonography parameters correlated significantly with pertechnetate scan results, demonstrating a comparable sensitivity of 96% and specificity of 95%. CONCLUSIONS: Differentiating Graves thyrotoxicosis from destructive thyrotoxicosis is essential for proper selection of therapy. Assessment of thyroid blood flow by color-flow Doppler ultrasonography is useful in this differentiation.
Authors:
K V S Hari Kumar; Vamsikrishna Pasupuleti; Muthukrishnan Jayaraman; Verma Abhyuday; Ramasubba Rayudu B; Kirtikumar D Modi
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists     Volume:  15     ISSN:  1934-2403     ISO Abbreviation:  Endocr Pract     Publication Date:    2009 Jan-Feb
Date Detail:
Created Date:  2009-02-12     Completed Date:  2009-05-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9607439     Medline TA:  Endocr Pract     Country:  United States    
Other Details:
Languages:  eng     Pagination:  6-9     Citation Subset:  IM    
Affiliation:
Department of Endocrinology, Medwin Hospitals, Nampally, India. hariendo@rediffmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Diagnosis, Differential
Female
Graves Disease / metabolism,  physiopathology,  ultrasonography*
Humans
Male
Middle Aged
Regional Blood Flow / physiology
Retrospective Studies
Sensitivity and Specificity
Thyroid Gland / blood supply,  metabolism
Thyrotoxicosis / metabolism,  physiopathology,  ultrasonography*
Thyrotropin / metabolism
Thyroxine / metabolism
Triiodothyronine / metabolism
Ultrasonography, Doppler, Color*
Chemical
Reg. No./Substance:
6893-02-3/Triiodothyronine; 7488-70-2/Thyroxine; 9002-71-5/Thyrotropin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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