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Cited by 144Thyroid Disorders and TreatmentsThyroid Cancer Diagnosis and TreatmentOphthalmology and Eye Disorders

Quantitative measurement of thyroid blood flow for differentiation of painless thyroiditis from Graves’ disease

Ota, Hisashi, Amino, Nobuyuki, Morita, Shinji, Kobayashi, Kaoru, Kubota, Sumihisa, Fukata, Shuji, Kamiyama, Naohisa, Miyauchi, Akira·2007·Clinical Endocrinology
DOI 10.1111/j.1365-2265.2007.02832.x
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Abstract

Summary: Objective Differentiation between destruction‐induced thyrotoxicosis and Graves’ thyrotoxicosis is important for selection of proper therapy. It is, however, often difficult to make this distinction without measurement of radioactive iodine uptake. We investigated the possibility that assessment of thyroid blood flow would allow differentiation between the two entities. Patients and measurements One hundred and fourteen untreated patients with thyrotoxicosis (56 Graves’ disease, 28 painless thyroiditis, 30 subacute thyroiditis) and 25 normal controls were examined. Serum levels of freeT4 (FT4), freeT3 (FT3) and TSH were measured by chemiluminescent immunoassay, and anti‐TSH receptor antibodies (TSH‐binding inhibitory immunoglobulin, TBII) were measured by enzyme‐linked immunosorbent assay. Thyroid volume and blood flow (TBF) were measured quantitatively by ultrasonography. Results TBF was significantly higher in Graves’ disease (mean ± 1SD: 14·9 ± 6·4%, P < 0·0001) than in painless thyroiditis (0·8 ± 0·5%), subacute thyroiditis (0·9 ± 0·7%) and in normal controls (0·8 ± 0·5%). All patients with Graves’ disease had TBF values of more than 4% and all patients with painless thyroiditis and subacute thyroiditis had TBF values less than 4%. TBF values significantly correlated with values of radioactive iodine uptake (RAIU) either at 3 h (r = 0·492, P < 0·01) or 24 h (r = 0·762, P < 0·001) within the Graves’ disease and painless thyroiditis groups. There was no relationship between TBF values and thyroid volumes or values of TBII in the Graves’ disease group. All patients with Graves’ disease had positive TBII of 15% or more. Three of 28 patients with painless thyroiditis and one of 30 patients with subacute thyroiditis had positive TBII. Conclusion TBF was quantitatively measured by power Doppler ultrasonography and was more effective than TBII for differentiation between destruction‐induced thyrotoxicosis (painless or subacute thyroiditis) and Graves’ thyrotoxicosis. TBF values of less than 4% in untreated thyrotoxic patients are laboratory signals of destruction‐induced thyrotoxicosis and if these are determined, the radioactive iodine uptake test can be omitted for differential diagnosis of these two types of thyrotoxicosis.

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Authors
Ota, H., Amino, N., Morita, S., Kobayashi, K., Kubota, S., Fukata, S., Kamiyama, N., & Miyauchi, A.
Affiliations
  • Kuma Hospital (JP)
  • Toshiba (Japan) (JP)
Corresponding author
Amino, Nobuyuki
ORCID
Venue
Clinical Endocrinology
Publisher
Wiley
Published
2007-04-27
Volume
67
Issue
1
Pages
41-45
ISSN
  • 0300-0664 (ISSN-L)
  • 1365-2265
DOI
10.1111/j.1365-2265.2007.02832.x
OpenAlex
W1983011372
Cited by
144
References
23
Citations by year
2026: 4 · 2025: 4 · 2024: 7 · 2023: 36 · 2022: 6 · 2021: 2 · 2020: 7 · 2019: 6 · 2018: 2 · 2017: 8 · 2016: 5 · 2015: 4 · 2014: 4 · 2013: 11 · 2012: 12
FWCI
4.87
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Clinical Endocrinology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Ophthalmology and Eye Disorders
Keywords
thyroid blood flow, painless thyroiditis, subacute thyroiditis, Graves' disease, thyrotoxicosis, differential diagnosis, power Doppler, TSH-binding inhibitory immunoglobulin, radioiodine uptake, thyroid volume, TSH receptor antibodies, thyroid destruction, thyroid hormone levels, thyroid-stimulating hormone, T3, thyroxine, treatment selection
MeSH terms
Adolescent, Adult, Aged, Diagnosis, Differential, Female, Graves Disease, Humans, Iodine Radioisotopes, Male, Middle Aged, Radionuclide Imaging, Regional Blood Flow, Thyroid Function Tests, Thyroid Gland, Thyroid Hormones, Thyroiditis, Linear Models, Case-Control Studies, Ultrasonography, Doppler, Pulsed, Statistics, Nonparametric

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