Thyroid blood flow evaluation by color-flow doppler sonography distinguishes Graves’ disease from Hashimoto’s thyroiditis

1995 ◽  
Vol 18 (11) ◽  
pp. 857-861 ◽  
Author(s):  
Paolo Vitti ◽  
T. Rago ◽  
S. Mazzeo ◽  
S. Brogioni ◽  
M. Lampis ◽  
...  
Keyword(s):  
Blood Flow ◽  
Hashimoto’S Thyroiditis ◽  
Doppler Sonography ◽  
Hashimoto's Thyroiditis ◽  
Graves Disease ◽  
Color Flow ◽  
Color Flow Doppler Sonography ◽  
Blood Flow Evaluation

scholarly journals Thyroid vascularity and blood flow are not dependent on serum thyroid hormone levels: studies in vivo by color flow doppler sonography

1999 ◽  
pp. 452-456 ◽  
Author(s):  
F Bogazzi ◽  
L Bartalena ◽  
S Brogioni ◽  
A Burelli ◽  
L Manetti ◽  
...  
Keyword(s):  
Blood Flow ◽  
Hashimoto’S Thyroiditis ◽  
Normal Subjects ◽  
Hashimoto's Thyroiditis ◽  
Graves Disease ◽  
Toxic Adenoma ◽  
Color Flow ◽  
Color Flow Doppler Sonography ◽  
Hypothyroid Patients

OBJECTIVE: Thyroid blood flow is greatly enhanced in untreated Graves' disease, but it is not known whether it is due to thyroid hormone excess or to thyroid hyperstimulation by TSH-receptor antibody. To address this issue in vivo patients with different thyroid disorders were submitted to color flow doppler sonography (CFDS). SUBJECTS AND METHODS: We investigated 24 normal subjects, and 78 patients with untreated hyperthyroidism (49 with Graves' hyperthyroidism, 24 with toxic adenoma, and 5 patients with TSH-secreting pituitary adenoma (TSHoma)), 19 patients with thyrotoxicosis (7 with thyrotoxicosis factitia, and 12 with subacute thyroiditis), 37 euthyroid patients with goitrous Hashimoto's thyroiditis, and 21 untreated hypothyroid patients with Hashimoto's thyroiditis. RESULTS: Normal subjects had CFDS pattern 0 (absent or minimal intraparenchimal spots) and mean intraparenchimal peak systolic velocity (PSV) of 4.8+/-1.2cm/s. Patients with spontaneous hyperthyroidism due to Graves' disease, TSHoma, and toxic adenoma had significantly increased PSV (P<0.0001, P=0.0004, P<0.0001 respectively vs controls) and CFDS pattern. Patients with Graves' disease had CFDS pattern II (mild increase of color flow doppler signal) in 10 (20%) and pattern III (marked increase) in 39 cases (80%). Mean PSV was 15+/-3cm/s. Patients with toxic adenoma had CFDS pattern I (presence of parenchymal blood flow with patchy uneven distribution) in 2 (8%), pattern II in 16 (70%) and pattern III in 5 (22%). Mean PSV was 11+/-2.4cm/s. Patients with TSHoma showed CFDS pattern I in one case (20%) and pattern II in 4 (80%). Mean PSV was 14.8+/-4.2cm/s. Patients with thyrotoxicosis had normal PSV (4.2+/-1. 1cm/s in subacute thyroiditis, 4+/-0.8cm/s in thyrotoxicosis factitia, P=not significant vs controls) and CFDS pattern 0. Untreated euthyroid patients with goitrous Hashimoto's thyroiditis had CFDS pattern 0, and mean PSV (4.3+/-0.9cm/s; P=not significant vs controls). Untreated hypothyroid patients with goitrous Hashimoto's thyroiditis had CFDS pattern I in 14 cases (67%), pattern II in 4 (19%) and pattern 0 in 3 (14%) and mean PSV (5.6+/-1. 4cm/s) was higher than that of controls (P=0.026). CONCLUSIONS: An increase in both intrathyroidal vascularity and blood velocity was observed in patients with spontaneous hyperthyroidism but not in thyrotoxicosis due to either ingestion of thyroid hormones or to a thyroidal destructive process. The slightly increased vascularity and blood velocity observed in patients with hypothyroid Hashimoto's thyroiditis suggests that thyroid stimulation by either TSH-receptor antibody or TSH is responsible for the increased thyroid blood flow.

scholarly journals Hypothyroid Hashimoto's Thyroiditis with Scintigraphic and Color Flow Doppler Sonography Features Mimicking a Hot Nodule

2009 ◽  
Vol 48 (4) ◽  
pp. 231-234 ◽  
Author(s):  
Ayhan Zengi ◽  
Muammer Karadeniz ◽  
Gulgun Demirpolat ◽  
Aysegul Akgun ◽  
Suleyman Karakose ◽  
...  
Keyword(s):  
Hashimoto’S Thyroiditis ◽  
Doppler Sonography ◽  
Hashimoto's Thyroiditis ◽  
Color Flow ◽  
Hot Nodule ◽  
Color Flow Doppler Sonography

Color-flow Doppler sonography in the differential diagnosis and management of amiodarone-induced thyrotoxicosis

2007 ◽  
Vol 48 (6) ◽  
pp. 628-634 ◽  
Author(s):  
M. Loy ◽  
E. Perra ◽  
A. Melis ◽  
M. E. Cianchetti ◽  
M. Piga ◽  
...  
Keyword(s):  
Blood Flow ◽  
Differential Diagnosis ◽  
Clinical Outcome ◽  
Doppler Sonography ◽  
Color Flow ◽  
Therapeutic Choice ◽  
Color Flow Doppler Sonography ◽  
Increased Blood Flow

Background: Amiodarone-induced thyrotoxicosis (AIT) may be caused by excessive thyroidal hormone synthesis and release (type 1) or by a destructive process (type 2). This differentiation is considered essential for therapeutic choice. Purpose: To evaluate the utility of color-flow Doppler sonography (CFDS) in the differential diagnosis and management of AIT. Material and Methods: The clinical and laboratory data, thyroid sonography (grayscale sonography [GSS], CFDS), thyroid radioiodine uptake (RAIU) and thyroid scintigraphy, treatment, and clinical outcome were retrospectively reviewed in 21 AIT patients. The CFDS pattern of thyroid nodules was separately described from that of the perinodular parenchyma, and AIT was classified as type 1 (increased blood flow) or type 2 (low/no blood flow). Type 1 AIT patients were treated with methimazole (alone or associated with potassium perchlorate), while type 2 patients were treated with prednisone or amiodarone withdrawal alone. Results: Eleven patients with increased blood flow were considered as type 1, and 10 with low/no blood flow as type 2. Ten of the 11 patients in the first group showed a hypervascular nodular pattern, while one showed a hypervascular parenchymal pattern. Clinical diagnoses were toxic nodular goiter and Graves' disease, respectively. Of the 10 patients with low/no blood flow, six had normal thyroid volume, three small diffuse goiter, and one small multinodular goiter. The clinical outcome showed that 20 of the 21 patients were treatment responsive. Conclusion: CFDS is a useful tool in the differential diagnosis of AIT. This differentiation appeared to be of clinical relevance as regards therapeutic choice. Separate evaluation of parenchymal blood flow from that of nodules may prove beneficial in the diagnosis of underlying thyroid diseases in patients with type 1 AIT.

scholarly journals Color flow doppler ultrasonography in Hashimoto’s Thyroiditis

2011 ◽  
Vol 10 (1) ◽  
pp. 14 ◽  
Author(s):  
Luis Jesuino De Oliveira Andrade ◽  
Maria Helena Ferreira Andrade ◽  
Thomaz Cruz ◽  
Larissa Santos França ◽  
Luciana Santos França ◽  
...  
Keyword(s):  
Blood Flow ◽  
Thyroid Gland ◽  
Hashimoto’S Thyroiditis ◽  
Doppler Ultrasonography ◽  
Peak Systolic Velocity ◽  
Inferior Thyroid Artery ◽  
Hashimoto's Thyroiditis ◽  
Pulsed Doppler ◽  
Color Flow ◽  
Conventional Ultrasound

<p class="MsoNormal" style="text-align: justify; line-height: normal; margin: 0cm 0cm 0pt;">Objective: To evaluate if the vascularization patterns in the thyroid gland parenchyma by the conventional ultrasound mode B, and color Doppler ultrasonography correlated with the peak systolic velocity (PSV) of the inferior thyroid artery using pulsed Doppler in patients with Hashimoto’s thyroiditis (HT) in various stages. Methods: Patients with diagnosis of HT were enrolled in this prospective study in the period two years. Thyroid glands of all patients were evaluated with conventional ultrasound mode B, color-flow Doppler ultrasonography, and peak systolic velocity (PSV) of the inferior thyroid artery. Data were analyzed applying variance (ANOVA) and Pearson’s or Spearman’s correlation. Results: A hundred twenty patients (10 men and 110 women) were included in the study. Highly elevated PSV were associated with very lower thyroid echogenicity and heterogeneous pattern thyroid gland (p= 0.01) and intrathyroidal blood flow (p= 0.004). Conclusions: We conclude that evaluation the vascularization patterns of the thyroid gland parenchyma in patients with HT when compared to conventional ultrasound mode B, and with the PSV of the inferior thyroid artery by pulsed Doppler showed a high correlation. Probably this method could be recommend as a measure of thyroid blood flow as an essential part of evaluating ultrasonography in the HT.</p>

scholarly journals Free thyroid hormons ration in patients with amiodaron-induced thyrotoxicosis type 1 and type 2

2018 ◽  
Vol 5 (3) ◽  
pp. 28-35
Author(s):  
E. O. Ulupova ◽  
G. A. Bogdanova ◽  
T. L. Karonova ◽  
E. N. Grineva
Keyword(s):  
Doppler Sonography ◽  
Graves Disease ◽  
Additional Test ◽  
Diagnostic Challenge ◽  
Color Flow ◽  
Serum T4 ◽  
Color Flow Doppler Sonography ◽  
Effect Of Treatment

Differentiation between amiodarone-induced thyrotoxicosis type 1 (AmIT1) and type 2 (AmIT2) is a diagnostic challenge. The current diagnostic tests are often unable to differentiate these two types of thyrotoxic syndrome. Several studies had shown that the serum T4 level and T3/T4 ratio are significantly different in patients with destructive thyroiditis, and those with Graves` disease. These studies showed that the serum T4 concentration is significantly higher, and the T3/T4 ratio is significantly lower in patients with destructive forms of thyroiditis compared to their values  in Graves’ disease. Since AmIT1 is known to develop in patients with latent Graves` disease, and AmIT2 is a destructive thyroiditis, the purpose of our study was to evaluate the serum FТ4 level and FT4/FT3 ratio in AmIT1 and AmIT2 as an additional diagnostic test for differentiating these types of thyrotoxicosis. 45 patients with thyrotoxicosis (33 with AmIT1 and 12 AmIT2) were included in the study. The diagnosis of thyrotoxicosis type (AmIT1 or AmIT2) was established on the basis of clinical data, color flow Doppler sonography (CFDS), the presence of TSH receptor autoantibody in patients with AmIT1, as well as the effect of treatment. There was no difference in FT3 levels in patients with AmIT1 and AmIT2, while the FT4 values were significantly higher in patients with AmIT2 (36,2±19,1 mmol/L) than in those with AmIT1 (17,8±3,7 mmol/L, p= 0,002). Also, a difference in the FT4/FT3 ratio was found between AmIT1 (2,7±0,8) and AmIT2 (6,1±5,7, p=0,048). Moreover, 75% of patients with AmIT1 had FT4/FT3ratio < 3,10, while 75% of patients with AmIT2 had FT4/FT3 ratio > 3,65. The FT4/FT3 ratio can be used as an additional test in the differential diagnosis AmIT1 and AmIT2.

scholarly journals Color-flow Doppler sonography in Graves disease: "thyroid inferno"

1988 ◽  
Vol 150 (4) ◽  
pp. 781-784 ◽  
Author(s):  
PW Ralls ◽  
DS Mayekawa ◽  
KP Lee ◽  
PM Colletti ◽  
DR Radin ◽  
...  
Keyword(s):  
Doppler Sonography ◽  
Graves Disease ◽  
Color Flow ◽  
Color Flow Doppler Sonography

Impact of the serum thyroglobulin concentration on the diagnostics of benign and malignant thyroid diseases

2000 ◽  
Vol 39 (05) ◽  
pp. 133-138 ◽  
Author(s):  
W. Dembowski ◽  
H.-J. Schroth ◽  
K. Klinger ◽  
Th. Rink
Keyword(s):  
Hashimoto’S Thyroiditis ◽  
Thyroid Volume ◽  
Nodular Goiter ◽  
Thyroid Diseases ◽  
Hashimoto's Thyroiditis ◽  
Graves Disease ◽  
Normal Range ◽  
Serum Thyroglobulin ◽  
Diffuse Goiter ◽  
Hyperthyroid Patients

Summary Aim of this study is to evaluate new and controversially discussed indications for determining the thyroglobulin (Tg) level in different thyroid diseases to support routine diagnostics. Methods: The following groups were included: 250 healthy subjects without goiter, 50 persons with diffuse goiter, 161 patients with multinodular goiter devoid of functional disorder (108 of them underwent surgery, in 17 cases carcinomas were detected), 60 hyperthyroid patients with autonomously functioning nodular goiter, 150 patients with Hashimoto’s thyroiditis and 30 hyperthyroid patients with Graves’ disease. Results: The upper limit of the normal range of the Tg level was calculated as 30 ng Tg/ml. The evaluation of the collective with diffuse goiter showed that the figure of the Tg level can be expected in a similar magnitude as the thyroid volume in milliliters. Nodular tissue led to far higher Tg values then presumed when considering the respective thyroid volume, with a rather high variance. A formula for a rough prediction of the Tg levels in nodular goiters is described. In ten out of 17 cases with thyroid carcinoma, the Tg was lower than estimated with thyroid and nodular volumes, but two patients showed a Tg exceeding 1000 ng/ml. The collective with functional autonomy had a significantly higher average Tg level than a matched euthyroid group being under suppressive levothyroxine substitution. However, due to the high variance of the Tg values, the autonomy could not consistently be predicted with the Tg level in individual cases. The patients with Hashimoto’s thyroiditis showed slightly decreased Tg levels. In Graves’ disease, a significantly higher average Tg level was observed compared with a matched group with diffuse goiter, but 47% of all Tg values were still in the normal range (< 30 ng/ml). Conclusion: Elevated Tg levels indicate a high probability of thyroid diseases, such as malignancy, autonomy or Graves’ disease. However, as low Tg concentrations cannot exclude the respective disorder, a routine Tg determination seems not to be justified in benign thyroid diseases.

Sign in / Sign up

Export Citation Format

Share Document