Role of Color Doppler Ultrasonography in Differentiation of Graves’ Disease from Thyroiditis: A Prospective Study

Rv, Suresh; Sundarram, KS Thalavai; Sadacharan, Dhalapathy; Ravindran, Krishnan; Kalpana, S

doi:10.5005/jp-journals-10002-1208

World Journal of Endocrine Surgery

2017

DOI: 10.5005/jp-journals-10002-1208

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Role of Color Doppler Ultrasonography in Differentiation of Graves’ Disease from Thyroiditis: A Prospective Study

Suresh Rv¹,

KS Thalavai Sundarram²,

Dhalapathy Sadacharan³

et al.

Abstract: Introduction: Thyrotoxicosis due to Graves' disease (GD) and destructive thyroiditis (DT) needs differentiation, as management strategy differs. Factors that help in diagnosis are biochemical and nuclear imaging. Utility of high-resolution ultrasonography (HRUSG) and color Doppler (CD) in differentiation is not widely practiced. We undertook the prospective study in the Department of Endocrine Surgery at a tertiary care center among South Indian population in 1 year as a cost-effective model

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Diagnostic Utility of Mean Peak Systolic Velocity of Superior Thyroid Artery in Differentiating Graves’ Disease from Thyroiditis

Sarangi

Parida²,

Mangaraj

et al. 2021

Indian J Radiol Imaging

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Background Differentiating Graves’ disease from thyroiditis can be at times clinically challenging. The gold standard test (thyroid nuclear imaging scan) is expensive, not routinely available, and has radiation exposure. Color Doppler ultrasonography of thyroid represents a suitable alternate which can be used for differentiating these conditions by studying thyroid blood flow parameters. Aim We aimed to investigate the use of thyroid blood flow parameters’ assessment of the superior thyroid artery (STA) and common carotid artery (CCA) with color Doppler ultrasonography for differentiating Graves’ disease from thyroiditis. Materials and Methods This is a cross-sectional study on 111 patients with newly diagnosed thyrotoxicosis (82 with Graves’ disease and 29 with thyroiditis) and 45 years of age and sex-matched healthy controls. All patients underwent detailed clinical and necessary investigations. Color Doppler ultrasonography of the thyroid gland and spectral flow analysis of both superior thyroid arteries was done using standard protocol. Sensitivity and specificity for mean peak systolic velocity of STA (STA-PSV) cut-offs were calculated using receiver operating characteristic curves. Results Patients with Graves’ disease have significantly higher free tri-iodothyronine (FT3) levels, free thyroxine (FT4) levels, antithyroid stimulating hormone receptor antibody (TRAb) levels, and thyroid volume as compared with those with thyroiditis. The mean STA-PSV of patients with Graves’ disease was significantly higher than thyroiditis and control group. Mean STA-PSV greater than 54.3 cm/s had 82.9% sensitivity and 86.2% specificity in diagnosing Graves’ disease. Mean PSV-STA/PSV-CCA ratio of 0.40 was 80.5% sensitive and 86.2% specific for Graves’ disease. Conclusion Mean STA-PSV has high sensitivity and specificity in differentiating Graves’ disease from thyroiditis and can be used routinely in clinical practice as a cheap and invaluable diagnostic tool.

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Diagnostic Utility of Mean Peak Systolic Velocity of Superior Thyroid Artery in Differentiating Graves’ Disease from Thyroiditis

Sarangi

Parida²,

Mangaraj

et al. 2021

Indian J Radiol Imaging

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Duplex Hemodynamic Parameters of Both Superior and Inferior Thyroid Arteries in Evaluation of Thyroid Hyperfunction Disorders

Hussein¹,

Hamid²,

Samie³

et al. 2022

IJGM

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Background Thyrotoxicosis may be caused by Graves’ disease or destructive thyroiditis. Differentiation between causes of thyrotoxicosis is crucial as management will differ. 99m Technetium (Tc)-pertechnetate thyroid scintigraphy is currently the gold standard for this purpose, however, is expensive and uses ionizing radiation. Objective To evaluate the role of color flow Doppler Ultrasound (CDU) of the superior thyroid (STA) and inferior thyroid arteries (ITA) as an inexpensive, non-invasive tool that can aid in differentiating between Graves’ disease and thyroiditis and compare it with thyroid scintigraphy. Methods Sixty-nine patients with newly-diagnosed thyrotoxicosis and 30 controls were enrolled. Thyroid functions, thyroid scintigraphy, and CDU of STA and ITA with measurements of peak systolic velocity (PSV) and end diastolic velocity (EDV), were performed. According to thyroid scintigraphy results, patients were divided into two groups: 42 patients with Graves’ disease and 27 patients with thyroiditis. Results PSV and EDV of both STA and ITA were significantly higher in patients with Graves’ disease than thyroiditis ( p -values <0.001). The STA-PSV had an equal sensitivity and specificity of 66.7%; cut-off value 76.57 cm/s, while those of STA-EDV were 73.8%, and 77.8% respectively; cut-off value 28.22 cm/s. ITA-PSV had a sensitivity and specificity of 76.2% and 77.8%, respectively; cut-off value 62.12 cm/s), while those of ITA-EDV were 78.6% and 77.8%, respectively; cut-off value 5.22 cm/s. Conclusion CDU parameters of the STA and ITA could be used as an alternative to thyroid scintigraphy for discriminating between Graves’ disease and thyroiditis.

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Inferior Thyroid Artery Doppler: A New Tool in Differentiation of Grave's Disease and Hashimoto's Thyroiditis. A Novel Radiological-Pathological Correlation Study

Rohan

Yogaisvariya

2022

IJAR

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Background: Autoimmune thyroid diseases are characterized by diffuse involvement of thyroid gland with hypoechogenicity and altered echotexture at gray scale ultrasound being a characteristic feature. An overlap of this pattern in patients affected by Graves' disease or Hashimoto's thyroiditis. Differentiation between causes of thyrotoxicosis at time of diagnosis, either hyperthyroidism due to Graves' disease or destructive thyrotoxicosis due to thyroiditis, is very important as management of each is completely different. Comparison of Doppler indices Aims and Objectives: in patients of Diffuse thyroid disease ( Graves' and Hashimoto's) on ultrasound with normal study population. Participants w Material & Methods ere recruited in the ultrasound unit at the Victoria hospital, Bangalore medical college and research institute. We conducted a prospective study on a group of 20 Normal individuals and 40 patients with Diffuse thyroid disease on Ultrasonography (20 cases of Hashimoto's thyroiditis and 20 cases of Graves disease). The thyroid glands of all patients were evaluated by gray scale ultrasonography for size, shape and echotexture. Color-ow Doppler ultrasonography of the thyroid tissue was performed and spectral ow analysis of both inferior thyroid arteries was assessed. Inferior thyroid artery Doppler parameters were calculated in all patients. Mean PSV of normal indivi Results duals was 16.4. Hashimoto's patients who had their mean PSV was 36.2 and Graves patients who had their mean PSV 86.4. On applying unpaired t test, the two tailed p value was less than 0.05 (0.001 and 0.0001 respectively), which found statistically highly signicant. The comparison of Doppler indices of Hashimotos disease and Graves diseases - On applying unpaired t test, the two tailed p value was less than 0.05 (0.0001) which was found statistically highly signicant. Blood Conclusion ow is a useful marker in initial diagnosis of diffuse thyroid. The high correlation between Doppler indices with pathological diagnosis establishes this modality as an acceptable alternative to Nuclear imaging. Its role in pregnancy and lactation where nuclear imaging is contraindicated needs to be emphasised.

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Role of Color Doppler Ultrasonography in Differentiation of Graves’ Disease from Thyroiditis: A Prospective Study

Cited by 3 publications

References 16 publications

Diagnostic Utility of Mean Peak Systolic Velocity of Superior Thyroid Artery in Differentiating Graves’ Disease from Thyroiditis

Diagnostic Utility of Mean Peak Systolic Velocity of Superior Thyroid Artery in Differentiating Graves’ Disease from Thyroiditis

Duplex Hemodynamic Parameters of Both Superior and Inferior Thyroid Arteries in Evaluation of Thyroid Hyperfunction Disorders

Inferior Thyroid Artery Doppler: A New Tool in Differentiation of Grave's Disease and Hashimoto's Thyroiditis. A Novel Radiological-Pathological Correlation Study

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