彩色多谱勒超声检测甲状腺下动脉血流速度在鉴别妊娠一过性甲状腺毒症与 Graves 病中的作用：一项前瞻性研究。
Is the measurement of inferior thyroid artery blood flow velocity by color-flow Doppler ultrasonography useful for differential diagnosis between gestational transient thyrotoxicosis and Graves' disease? A prospective study.
机构信息
Sisli Etfal Training and Research Hospital, Endocrinology and Metabolism Clinic, Istanbul, Turkey.
出版信息
Clinics (Sao Paulo). 2012;67(2):125-9. doi: 10.6061/clinics/2012(02)06.
OBJECTIVE
To determine the role of peak systolic velocity, end-diastolic velocity and resistance indices of both the right and left inferior thyroid arteries measured by color-flow Doppler ultrasonography for a differential diagnosis between gestational transient thyrotoxicosis and Graves' disease during pregnancy.
METHODS
The right and left inferior thyroid artery-peak systolic velocity, end-diastolic velocity and resistance indices of 96 patients with thyrotoxicosis (41 with gestational transient thyrotoxicosis, 31 age-matched pregnant patients with Graves' disease and 24 age- and sex-matched non-pregnant patients with Graves' disease) and 25 age and sex-matched healthy euthyroid subjects were assessed with color-flow Doppler ultrasonography.
RESULTS
The right and left inferior thyroid artery-peak systolic and end-diastolic velocities in patients with gestational transient thyrotoxicosis were found to be significantly lower than those of pregnant patients with Graves' disease and higher than those of healthy euthyroid subjects. However, the right and left inferior thyroid artery peak systolic and end-diastolic velocities in pregnant patients with Graves' disease were significantly lower than those of non-pregnant patients with Graves' disease. The right and left inferior thyroid artery peak systolic and end-diastolic velocities were positively correlated with TSH-receptor antibody levels. We found an overlap between the inferior thyroid artery-blood flow velocities in a considerable number of patients with gestational transient thyrotoxicosis and pregnant patients with Graves' disease.
CONCLUSIONS
This study suggests that the measurement of inferior thyroid artery-blood flow velocities with color-flow Doppler ultrasonography does not have sufficient sensitivity and specificity to be recommended as an initial diagnostic test for a differential diagnosis between gestational transient thyrotoxicosis and Graves' disease during pregnancy.
目的
通过彩色多谱勒超声测定甲状腺下动脉收缩期峰值速度、舒张末期速度及阻力指数，探讨其在妊娠一过性甲状腺毒症与Graves 病鉴别诊断中的作用。
方法
采用彩色多谱勒超声对 96 例甲状腺毒症患者（妊娠期一过性甲状腺毒症 41 例，Graves 病妊娠组 31 例，Graves 病非妊娠组 24 例）和 25 例健康对照组的甲状腺下动脉收缩期峰值速度、舒张末期速度及阻力指数进行检测。
结果
妊娠期一过性甲状腺毒症患者甲状腺下动脉收缩期峰值速度和舒张末期速度明显低于 Graves 病妊娠组，高于健康对照组；而 Graves 病妊娠组甲状腺下动脉收缩期峰值速度和舒张末期速度明显低于 Graves 病非妊娠组。甲状腺下动脉收缩期峰值速度和舒张末期速度与 TSH 受体抗体水平呈正相关。在相当数量的妊娠期一过性甲状腺毒症患者和 Graves 病妊娠组患者中，甲状腺下动脉血流速度存在重叠。
结论
彩色多谱勒超声测定甲状腺下动脉血流速度对妊娠期一过性甲状腺毒症与 Graves 病的鉴别诊断缺乏足够的敏感性和特异性，不建议作为首选的鉴别诊断方法。
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