ndocrine Institute, Haemek Medical Center, Afula, Israel.
Endocr Pract. 2010 May-Jun;16(3):376-81. doi: 10.4158/EP09218.OR.
To assess the value of color-flow Doppler sonography (CFDS) in evaluating intrathyroidal blood flow and velocity in patients with subclinical thyroid dysfunction.
In 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 se-rum free thyroxine (FT4) and free triiodothyronine (FT3) in the presence of high (subclinical hypothyroidism), or low-suppressed (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 hyperthyroid-ism. 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.
The 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.
We have demonstrated that significantly increased thyroid blood flow velocity and vascularity are already present in patients with mild thyroid dysfunction.
评估彩色多谱勒超声（CFDS）在评估亚临床甲状腺功能减退症患者甲状腺内血流和速度中的价值。
本前瞻性研究纳入了亚临床甲状腺功能减退症患者、亚临床甲状腺功能亢进症患者和作为对照组的甲状腺自身免疫性疾病无已知的甲状腺功能正常患者。亚临床甲状腺功能减退症定义为血清游离甲状腺素（FT4）和游离三碘甲状腺原氨酸（FT3）正常，而促甲状腺激素（TSH）水平升高（亚临床甲状腺功能减退症）或抑制（亚临床甲状腺功能亢进症）。所有参与者均检测血清 FT4、FT3、TSH、甲状腺过氧化物酶和甲状腺球蛋白抗体。此外，还测定了亚临床甲状腺功能亢进症患者的促甲状腺素受体抗体水平。所有参与者均进行常规超声和 CFDS 检查。从多个甲状腺实质结节取样和甲状腺下动脉测量中获得平均峰值收缩速度（PSV）和阻力指数。
研究人群包括 27 例亚临床甲状腺功能减退症患者、15 例亚临床甲状腺功能亢进症患者和 20 例甲状腺功能正常患者。亚临床甲状腺功能减退症患者的甲状腺内 PSV 值明显高于对照组患者（19.9±5.6cm/s 比 15.7±4.4cm/s；P=0.008），而亚临床甲状腺功能亢进症患者的甲状腺下动脉 PSV 值明显高于对照组患者（29.7±10.7cm/s 比 21.9±6.8cm/s；P=0.014）。与对照组患者相比，亚临床甲状腺功能减退症患者和亚临床甲状腺功能亢进症患者中，有更多的患者出现明显的 CFDS 模式（78%比 15%[P<0.001]和 53%比 15%[P<0.001]）。甲状腺自身抗体阳性与强烈的 CFDS 模式之间存在显著相关性。TSH 或甲状腺激素水平与 CFDS 模式或血流速度之间无相关性。
我们已经证明，在轻度甲状腺功能减退症患者中，甲状腺血流速度和血管明显增加。
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