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Evaluation of usefulness of a new blood flow index, pulsatile flow/nonpulsatile flow ratio, by pulsatile flow detection ultrasonography

2003; Elsevier BV; Volume: 29; Issue: 5 Linguagem: Inglês

10.1016/s0301-5629(03)00642-2

1879-291X

Toshiaki Shirakawa, Junya Yamagishi, Yosuke Miyamoto, Takeo Irie, Kunihiko Fukuda,

Ultrasound Imaging and Elastography

Objective: The aim of this study was to clarify the usefulness of a new index, pulsatile flow/nonpulsatile flow ratio (P/NP), on PFD-US (pulsatile flow detection ultrasonography) for differential diagnosis between Graves' disease and Hashimoto's thyroiditis with hypervascular status. PFD-US is a novel ultrasonographic power Doppler technology, which can demonstrate pulsatile flow and nonpulsatile flow as different colors in real time. It is impossible to differentiate Graves' disease and Hashimoto's thyroiditis with hypervascular status by either only conventional color/power Doppler imaging or other modalities such as CT or MRI. We proposed a new index, P/NP, and we evaluated usefulness of the new index. Methods: The following people were examined by PFD-US using 9 MHz electronic linear array transducer with LOGIQ 500 (GE medical systems): 47 patients with diffuse thyroid disease (27 with untreated Graves' disease and 20 with Hashimoto's thyroiditis with hypervascular status on conventional color/power Doppler imaging). Some PFD parameters were adjusted for good sensitivity of blood flow pulsatility. Obtained images of all cases were analyzed by using an application software of Photoshop 5.5 (Adobe Systems Inc.) on personal computer (Power Macintosh G4). On this program, total pixels of all pulsatile flow and all nonpulsatile flow were counted respectively, and we calculated the P/NP. Results: Mean P/NP of Graves' disease (3.44±0.84, mean±standard error) were statistically higher (p=0.01) than those of Hashimoto's thyroiditis (0.81±0.16). There was no relationship between T3 and P/NP (r=0.21) and between T4 and P/NP (r=0.12) in Graves' disease. Conclusions: P/NP on PFD-US can easily differentiate between Graves' disease and Hashimoto's thyroiditis with hypervascular status in real time. P/NP can be a new useful index for the differential diagnosis of diseases.