Autoimmune thyroid disease: arterial spin-labeling perfusion MR imaging.
OBJECTIVE
To assess thyroid perfusion in patients with autoimmune thyroid diseases compared with that in healthy control subjects by using an arterial spin-labeling (ASL) magnetic resonance (MR) technique and to assess whether thyroid perfusion is associated with endocrine laboratory abnormalities.


METHODS
This study was approved by the local institutional review board. All participants gave written informed consent. Perfusion imaging of the thyroid gland was performed in 10 patients with Graves disease (GD) and 10 patients with Hashimoto thyroiditis (HT). Ten healthy individuals served as control subjects. Perfusion imaging was performed with a 1.5-T MR unit by using a flow-sensitive alternating inversion recovery-true fast imaging with steady-state precession technique. Perfusion maps of the entire thyroid gland were calculated on the basis of extended Bloch equations. Analysis of variance with a post hoc test (Tukey honestly significant difference) was performed to assess differences in perfusion between groups. Associations between perfusion and laboratory parameters were analyzed with univariate regression analysis.


RESULTS
Mean thyroid perfusion was 1596 mL/min/100 g +/- 436 (standard deviation) in patients with GD, 825 mL/min/100 g +/- 264 in patients with HT, and 491 mL/min/100 g +/- 89 in healthy control subjects. Perfusion was significantly higher in patients with GD (P < .0001) and those with HT (P < .05) than in control subjects. A significant difference in thyroid perfusion was detected between the two autoimmune entities (P < .0001). In patients with GD, significant associations were found between perfusion and serum concentrations of free thyroid hormones and anti-thyroid-stimulating hormone receptor antibodies (P < .05 for all).


CONCLUSIONS
Quantitative ASL perfusion imaging of the thyroid gland revealed significant perfusion differences in the autoimmune thyroid diseases GD and HT. Absolute quantification of thyroid perfusion may be useful in the clinical assessment of autoimmune thyroid disorders and when monitoring therapeutic treatment in GD.
Section on Experimental Radiology, Department of Diagnostic and Interventional Radiology, and Division of Endocrinology, Diabetes, Nephrology, Angiology, and Clinical Chemistry, University Hospital of Tübingen, Hoppe-Seyler-Str 3, 72076 Tübingen, Germany. christina.schraml@med.uni-tuebingen.de
Christina
C
Schraml
Karsten
K
Müssig
Petros
P
Martirosian
Nina F
NF
Schwenzer
Claus D
CD
Claussen
Hans-Ulrich
HU
Häring
Bernd M
BM
Balletshofer
Fritz
F
Schick
D000328:Adult; D005260:Female; D006111:Graves Disease / Q000175:diagnosis; D050031:Hashimoto Disease / Q000175:diagnosis; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D013113:Spin Labels; D013961:Thyroid Gland / Q000098:blood supply* / Q000473:pathology; D013967:Thyroiditis, Autoimmune / Q000175:diagnosis*; D055815:Young Adult
D013113:Spin Labels