Abstract

To determine thyroid vascularity in healthy subjects and patients with autoimmune thyroid disease (AITD), and assess its sensitivity and specificity for the diagnosis of AITD. High-sensitivity color flow Doppler sonography (HSCFDS) was used to estimate the thyroid intraparenchymal vascularity in 31 euthyroid patients with Hashimoto's thyroiditis (HD), 33 hypothyroid patients with HD, 13 hyperthyroid patients with Graves' disease, and in 34 healthy controls. Images obtained from the ultrasound unit were further processed with a widespread, available imaging analysis program and the predictive value of the maximum vascularity index (VI) was used for further statistical analysis. Compared to healthy controls, patients with AITD had higher mean VI of both the right and the left thyroid lobe (TL) (P < 0.001). The sensitivity of left TL VI values greater than 5.57% (the best cut-off value of the Receiver Operating Characteristics-ROC curve) for the diagnosis of AITD was 80.8% and the specificity was 85.3%. Right TL VI values greater than 14.75% had 84.6% sensitivity and 86.2% specificity for the differential diagnosis among patients with HT or GD. Measurement of right and left TL vascularity index using HSCFDS is a high specific tool, particularly where there is a high clinical suspicion of an autoimmune process.

Highlights

  • Aim: to determine thyroid vascularity in healthy subjects and patients with autoimmune thyroid disease (AITD), and assess its sensitivity and specificity for the diagnosis of AITD

  • No statistically significant differences were observed in mean vascularity index (VI) (%) of the right and the left thyroid lobe (TL) among controls (3.86 ± 3.91 vs 3.78 ± 3.4, P = 0.844), patients with AITD type-1 (9.58 ± 5.86 vs 10.26 ± 7.43, P = 0.5), patients with AITD type-2 (13.4 ± 13.49 vs 14.03 ± 16.42, P = 0.657), and patients with AITD type-3 (32.53 ± 15.45 vs 30.73 ± 14.27, P = 0.673)

  • Patients with AITD type-1, AITD type2, and AITD type-3 exhibited higher mean VI (%) measurements of both the right and the left TL compared to controls (8.22 ± 5.78, 13.49 ± 12.75, 26.42 ± 15.45, 3.63 ± 3.84, P < 0.001, and 9.49 ± 6.87, 13.8 ± 14.74, 24.67 ± 14.27, 3.45 ± 3.54, P < 0.001, respectively)

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Summary

Introduction

Aim: to determine thyroid vascularity in healthy subjects and patients with autoimmune thyroid disease (AITD), and assess its sensitivity and specificity for the diagnosis of AITD. There are no available data regarding the predictive value of CFDS assessed thyroid vascularity for the diagnosis of autoimmune thyroid disease (AITD) per se and potential correlations with clinical or biochemical parameters. The main purpose of this study is to determine thyroid vascularity with a semi-quantitative, widespread available method in healthy subjects and in patients with AITD [Hashimoto’s thyroiditis (HT) and Graves’ disease (GD)], and to assess its sensitivity and specificity for the diagnosis of AITD and for the differential diagnosis between patients with HT and GD. Secondary goals are to correlate thyroid vascularity with clinical and biochemical indices

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