Selçuk Can Tuba, Özdemir Sevim, İkizceli Türkan, Yılmaz Behice Kaniye, Sarı Mehmet Akif, Türkay Rüştü, Doğan Özlem
University of Health Sciences Türkiye, İstanbul Haseki Training and Research Hospital, Clinic of Radiology, İstanbul, Türkiye.
University of Health Sciences Türkiye, Kanuni Sultan Süleyman Training and Research Hospital, Clinic of Radiology, İstanbul, Türkiye.
Diagn Interv Radiol. 2025 Aug 27. doi: 10.4274/dir.2025.253311.
To quantitatively evaluate the vascularity of the thyroid parenchyma in patients diagnosed with Hashimoto's thyroiditis (HT) compared with healthy controls by using vascularity index (VI) through power Doppler (PD) and color superb microvascular imaging (cSMI) and to determine a threshold VI value to effectively differentiate patients with HT and hypothyroid HT.
This prospective cross-sectional study involved 73 patients diagnosed with HT and 66 healthy controls. The diagnosis of HT was established based on clinical and laboratory findings. The total volume of the thyroid gland was measured, and the region of interest was drawn manually by delineating the gland boundaries for VI calculation on PD and cSMI. The mean VI for both lobes of the thyroid were computed for each participant. Statistical analyses were conducted using SPSS version 29.0, with receiver operating characteristic curve analysis employed to ascertain the optimal cSMI VI cut-off values for the diagnosis of HT and for patients with hypothyroid HT.
The analysis revealed no significant differences in the total thyroid volume between the HT group and the control group, or between the hypothyroid and euthyroid HT subgroups. The SMI VI values were recorded at 8.85 [interquartile range (IQR): 25%-75%, 6.55-12.6] for patients with HT and 8.40 (IQR: 25%-75%, 6.70-12.8) for the control group, indicating a statistically significant increase in the HT cohort ( < 0.001). Additionally, the PD VI values in patients with HT were significantly higher than in the control group ( < 0.001). A strong positive correlation was identified between thyroid-stimulating hormone levels and cSMI VI in patients with HT (rho = 0.739, < 0.001), whereas the correlation with PD VI was found to be weak (rho = 0.346, < 0.001). The optimal cut-off value for SMI VI was 6.75% for the general diagnosis of HT and 8.825% for patients with hypothyroid HT.
This study indicates that the optimal threshold values of 6.75% for the diagnosis of HT and 8.825% for patients with hypothyroid HT suggest that cSMI is an effective and promising diagnostic tool for detecting alterations in thyroid vascularization. Furthermore, there is a strong concordance among radiologists regarding the VI measurements.
The SMI technique represents a promising diagnostic tool for the detection of subtle alterations in thyroid vascularization. The higher sensitivity of cSMI in comparison to PD positions it as an innovative and effective technology for the assessment of HT, offering valuable insights into disease activity and progression.
通过功率多普勒（PD）和彩色超微血管成像（cSMI）使用血管指数（VI），定量评估诊断为桥本甲状腺炎（HT）的患者与健康对照者甲状腺实质的血管情况，并确定一个阈值VI值以有效区分HT患者和甲状腺功能减退的HT患者。
这项前瞻性横断面研究纳入了73例诊断为HT的患者和66例健康对照者。HT的诊断基于临床和实验室检查结果。测量甲状腺的总体积，并通过在PD和cSMI上描绘腺体边界手动绘制感兴趣区域以计算VI。计算每个参与者甲状腺两叶的平均VI。使用SPSS 29.0进行统计分析，采用受试者工作特征曲线分析来确定用于诊断HT和甲状腺功能减退的HT患者的最佳cSMI VI临界值。
分析显示，HT组与对照组之间，以及甲状腺功能减退和甲状腺功能正常的HT亚组之间，甲状腺总体积无显著差异。HT患者的SMI VI值为8.85[四分位间距（IQR）：25%-75%，6.55-12.6]，对照组为8.40（IQR：25%-75%，6.70-12.8），表明HT队列有统计学显著增加（<0.001）。此外，HT患者的PD VI值显著高于对照组（<0.001）。HT患者促甲状腺激素水平与cSMI VI之间存在强正相关（rho = 0.739，<0.001），而与PD VI的相关性较弱（rho = 0.346，<0.001）。SMI VI的最佳临界值对于HT的总体诊断为6.75%，对于甲状腺功能减退的HT患者为8.825%。
本研究表明，诊断HT的最佳阈值为6.75%，甲状腺功能减退的HT患者为8.825%，这表明cSMI是检测甲状腺血管化改变的一种有效且有前景的诊断工具。此外，放射科医生在VI测量方面有很强的一致性。
SMI技术是检测甲状腺血管化细微改变的一种有前景的诊断工具。与PD相比，cSMI的更高灵敏度使其成为评估HT的一种创新且有效的技术，为疾病活动和进展提供有价值的见解。
