Spectral flow Doppler features and hemodynamics parameters of nodular hyperthyroidism and goiter

Abstract

Objective To study the spectrum characteristics and changes of blood flow parameters of patients with nodular hyperthyroidism and goiter. Methods The thyroid thickness and area, as well as the peak systolic velocity (PSV), end diastolic velocity (EDV), and resistance index (RI) of superior thyroid artery (STA), in the patients with hyperthyroidism (43 cases) and nodular goiter (41 cases) and in the normal persons (40 cases) were observed by color Doppler ultrasonic diagnosis instrument. Results There were certain changes of two-dimensional echocardiography in the patients with nodular hyperthyroidism and goiter, but difficult to distinguish. The thyroid thickness and area were (14.48±3.04) mm and (1.28±0.31) cm2 in the normal group; were (23.31±4.34) mm and (2.59±0.57) cm2 in the nodular goiter group; and were (22.65±5.05) mm and (2.63±0.61) cm2 in the nodular hyperthyroidism group; with statistical differences between the normal group on one hand and the nodular hyperthyroidism group and the nodular goiter group on the other hand (P 0.05). Different from those of the nodular goiter group, the spectrum characteristics of the nodular hyperthyroidism group were high and sharp at the first peak, low at the second peak, and even had two peaks becoming fusion, extending, and backward. The inner diameter, average velocity, and blood flow of STA were (0.13±0.02) cm, (21.35±8.89) cm/s, and (15.03±7.24) ml/min in the normal group; were (0.19±0.03) cm, (39.53±20.38) cm/s, and (70.78±30.78) ml/min in the nodular goiter group; and were (0.24±0.05) cm, (57.67±25.46) cm/s, and (105.11±35.28) ml/min in the nodular hyperthyroidism group; with statistical differences between these 3 groups (P<0.01 or P<0.05). The PSV, EDV, and RI of STA were (12.43±5.70) cm/s, (6.03±2.91) cm/s, and (0.51±0.08) cm/s in the normal group; were (15.45±7.68) cm/s, (6.41±3.44) cm/s, and (0.53±0.08) cm/s in the nodular goiter group; and were (24.33±10.15) cm/s, (6.61±5.15) cm/s, and (0.60±0.09) cm/s in the nodular hyperthyroidism group; the PSV and RI were higher in the nodular hyperthyroidism group than those in the normal group and the nodular goiter group (P<0.05 or P<0.01). Conclusions These main characteristics in STA, such as increasing blood flow, high and sharp at the first peak, low at the second peak, and two peaks becoming fusion, extending, and backward, as well as inner diameter broadening, speeding-up flow, and increasing blood flow, could contribute to the differential diagnosis of the nodular hyperthyroidism and nodular goiter. Key words: Nodular hyperthyroidism; Color Doppler ultrasound; Hemodynamics; Blood flow spectrum