ROLE OF DOPPLER EVALUATION OF THYROID GLAND IN DIFFERENTIATING GRAVES’ DISEASE FROM OTHER THYROTOXIC STATES
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2018, Vol 5, Issue 24
Abstract
BACKGROUND Differentiation between thyroiditis induced thyrotoxicosis and Graves' disease is needed for selection of proper therapy. It is often difficult to differentiate between them without performing thyroid scintigraphy. Colour Flow Doppler Sonography (CFDS) is gaining importance for the functional evaluation of the thyroid diseases. The purpose of the study was to determine the value of CFDS for differentiating between thyroiditis induced thyrotoxicosis and Graves’ disease. MATERIALS AND METHODS Fifty patients with clinical and lab signs of hyperthyroidism were evaluated. Clinical history was taken, and physical examination and thyroid function tests were performed for all patients. Conventional grey scale sonography was done, followed by CFDS. Peak systolic velocity (PSV) measurements were obtained from both inferior thyroid arteries. Results were compared with Technetium 99 scanning which was used as a golden standard. The patients were divided into two groups: 32 cases with Graves’ disease and 18 cases with thyroiditis based on thyroid scintigraphy. The patients had suppressed TSH levels and clinical symptoms also supported the diagnosis. RESULTS The Peak systolic velocity of right inferior thyroid artery was found to be elevated in patients with Graves’ disease than in patients with thyroiditis (P <0.001 in right inferior thyroid artery). It had a sensitivity of 90.6% and a specificity of 88.9% in differentiating the causes of thyrotoxicosis. CONCLUSION Peak systolic velocity is an inexpensive, fast, and noninvasive imaging procedure. Hence it will be very useful in the differential diagnosis of thyrotoxicosis, especially when thyroid scintigraphy by radioactive materials is contraindicated in special situations like pregnancy and in places where nuclear imaging is not easily accessible.
Authors and Affiliations
Jerry George, Mattavana Ramakrishna Pillai Balachandran Nair, Kiran Thilakarajan
Keywords
Related Articles
- EP ID EP566983
- DOI 10.18410/jebmh/2018/375
- Views 71
- Downloads 0
PROCALCITONIN AS A DIAGNOSTIC MARKER OF NEONATAL SEPSIS
Neonatal sepsis is difficult to diagnose because it is associated with nonspecific signs and symptoms and a high index of suspicion is required for early diagnosis. Several acute phase reactants help to indicate the pres...
VARIATIONS IN DIVISION OF SCIATIC NERVE: A CADAVERIC STUDY
INTRODUCTION Sciatic nerve is the largest and thickest nerve in the body. It arises from the lumbar plexus within the pelvis. The nerve emerges from the pelvis to enter into its component nerves –tibial and common perone...
DUAL ENDOCRINOPATHY- THE NEXUS BETWEEN HYPERGLYCAEMIA (GESTATIONAL DIABETES) AND HYPOTHYROIDISM AMONG PREGNANT WOMEN IN INDIA
BACKGROUND There have been rising trends in the incidence of hyperglycaemia in pregnancy and hypothyroidism in pregnancy. Both are known to cause adverse maternal and foetal outcomes. An attempt is being made to look at...
PREVALENCE OF CHOLESTATIC JAUNDICE IN CHILDREN – A STUDY IN HOSPITALISED CHILDREN
INTRODUCTION A study conducted in 58 cases of children who were admitted and evaluated over a period of 2 years October 2013 to November 2015 to find out the prevalence of cholestatic jaundice in children. This study con...
A COMPARATIVE STUDY OF PRIMARY AND SECONDARY CLOSURE OF SURGICAL WOUNDS AFTER REMOVAL OF IMPACTED MANDIBULAR MOLAR
BACKGROUND Study was performed to compare primary and secondary closure of surgical wound after surgical removal of third molar. Conflicting opinion has been expressed in the literature. MATERIALS AND METHODS This study...