Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Sep 9:15:7131-7144.
doi: 10.2147/IJGM.S375016. eCollection 2022.

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

Maha Assem Hussein  1 , Alaa Abdel Hamid  2 , Rasha M Abdel Samie  1 , Elshaymaa Hussein  3 , Shereen Sadik Elsawy  1
Affiliations

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

Maha Assem Hussein et al. Int J Gen Med. .

Abstract

Background: Thyrotoxicosis may be caused by Graves' disease or destructive thyroiditis. Differentiation between causes of thyrotoxicosis is crucial as management will differ. 99mTechnetium (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.

Keywords: Color Doppler Flow Ultrasound; Graves’ disease; end-diastolic velocity; peak systolic velocity; thyroiditis.

PubMed Disclaimer

Conflict of interest statement

No conflict of interest to declare.

Figures

Figure 1
Figure 1
Flow chart showing patient selection.
Figure 2
Figure 2
Showing images of color Doppler ultrasound and spectral Doppler flow analysis of a patient with Graves’s disease. (A) Right lobe of thyroid gland showing a diffuse increase in the thyroid gland vascularity on color Doppler. (B) Spectral Doppler flow examination of the right ITA showing an increased peak systolic velocity (89.2 cm/s) and an increased end-diastolic velocity of 31.2 cm/s.
Figure 3
Figure 3
Color Doppler hemodynamic parameters of the left inferior thyroid artery in a patient with thyroiditis showing a peak systolic velocity (PSV) of 17.3 cm/s, end-diastolic velocity (EDV) of 9.32 cm/s, and Resistive index (RI) of 0.46.
Figure 4
Figure 4
(A) represents reduced tracer uptake in thyroiditis while (B) represents diffuse increase of radiotracer uptake in Grave’s disease.
Figure 5
Figure 5
ROC curve analysis for the mean STA-PSV (A) and the mean STA-EDV (B) in differentiating between Graves’ disease and thyroiditis.
Figure 6
Figure 6
ROC curve analysis for the mean ITA-PSV (A) and mean ITA-EDV (B) in differentiating between Graves’ disease and thyroiditis.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Donkol RH, Nada AM, Boughattas S. Role of color Doppler in differentiation of Graves’ disease and thyroiditis in thyrotoxicosis. World J Radiol. 2013;5(4):178–183. doi:10.4329/wjr.v5.i4.178 - DOI - PMC - PubMed
    1. Amino N, Yabu Y, Miyai K. Differentiation of thyrotoxicosis induced by thyroid destruction from Graves’disease. Lancet. 1978;2:344–346. doi:10.1016/S0140-6736(78)92943-4 - DOI - PubMed
    1. Lee JC. Thyroid scans. Aust Fam Physician. 2012;41(8):1–3. - PubMed
    1. Kumar KV, Pasupuleti V, Jayaraman M, Abhyuday V, Rayudu BR, Modi KD. Role of thyroid Doppler in differential diagnosis of thyrotoxicosis. Endocr Pract. 2009;15(1):6–9. doi:10.4158/EP.15.1.6 - DOI - PubMed
    1. Kahaly GJ, Diana T, Kanitz M, Frommer L, Olivo PD. Prospective trial of functional thyrotropin receptor antibodies in Graves disease. J Clin Endocrinol Metab. 2020;105(4):e1006–14. doi:10.1210/clinem/dgz292 - DOI - PMC - PubMed

LinkOut - more resources