Color-Flow Doppler Sonography in Patients with Subclinical Thyroid Dysfunction |
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| Institution: | 1. Endocrine Institute, Haemek Medical Center, Afula, Israel;2. Department of Radiology, Haemek Medical Center, Afula, Israel;3. Department of Community Medicine and Epidemiology, Carmel Medical Center, Haifa, Israel;4. B. Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.;1. College of Medicine-Phoenix, University of Arizona, Phoenix, AZ, United States;2. Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States;3. College of Medicine, University of Cincinnati, Cincinnati, OH, United States;4. Geriatric Research Education and Clinical Center, VA Boston Medical Center, Boston, MA, United States;5. Division of Aging, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States;1. Graduate Program in Pathology, Universidade Federal de Ciencias da Saude de Porto Alegre (UFCSPA), Brazil;2. Neuroendocrinology Center, Complexo Hospitalar Santa Casa de Porto Alegre/UFCSPA, Brazil.;1. Saarland University, Department of Internal Medicine II, Kirrberger Str. 100, 66421 Homburg/Saar, Germany;2. Department of Internal Medicine V, Saarland University, Germany;3. Department of Neu, Klinikum Saarbruecken, Germany;4. Department of Neurology, University of Muenster, Germany |
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| Abstract: | ObjectiveTo assess the value of color-flow Doppler sonography (CFDS) in evaluating intrathyroidal blood flow and velocity in patients with subclinical thyroid dysfunction.MethodsIn this prospective study, patients with subclinical hypothyroidism, patients with subclinical hyperthyroidism, and euthyroid patients without known thyroid autoimmune disease who served as controls were included. Subclinical thyroid dysfunction was defined as normal serum free thyroxine (FT4) and free triiodothyronine (FT3) in the presence of high (subclinical hypothyroidism), or lowsuppressed (subclinical hyperthyroidism) serum thyrotropin (TSH) levels. Serum FT4, FT3, TSH, and antibodies to thyroid peroxidase and thyroglobulin were measured in all participants. In addition, TSH receptor antibody levels were determined in patients with subclinical hyperthyroidism. All participants underwent conventional sonography and CFDS. Mean peak systolic velocity (PSV) and resistive index were obtained from multiple extranodular thyroid parenchyma samplings and inferior thyroid artery measurements.ResultsThe study population included 27 patients with subclinical hypothyroidism, 15 patients with subclinical hyperthyroidism, and 20 euthyroid patients. Patients with subclinical hypothyroidism had significantly higher mean intrathyroidal PSV values than control patients (19.9 ± 5.6 cm/s vs 15.7 ± 4.4 cm/s; P = .008), whereas patients with subclinical hyperthyroidism had significantly higher mean PSV values than control patients at the inferior thyroid artery level (29.7 ± 10.7 cm/s vs 21.9 ± 6.8 cm/s; P = .014). Compared with control patients, a greater proportion of patients with subclinical hypothyroidism and patients with subclinical hyperthyroidism had marked CFDS patterns (78% vs 15% P <.001] and 53% vs 15%; P <.001], respectively). A significant association was found between positivity for thyroid autoantibodies and intense CFDS patterns. No correlation was found between TSH or thyroid hormone levels and CFDS pattern or blood flow velocity.ConclusionWe have demonstrated that significantly increased thyroid blood flow velocity and vascularity are already present in patients with mild thyroid dysfunction.(Endocr Pract. 2010;16:376-381) |
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