title: Characteristics of patients with graves disease and intrathyroid hypovascularity compared to painless thyroiditis.
abstract: OBJECTIVE
  The purpose of this study was to assess the frequency and sonographic and laboratory characteristics of Graves disease with intrathyroid hypovascularity in Japanese patients and to compare these characteristics in patients with painless thyroiditis.
  
  
  METHODS
  A total of 194 consecutive patients with Graves disease and 21 patients with painless thyroiditis were enrolled. The patients underwent thyroid volume measurement, mean superior thyroid artery peak systolic velocity (PSV) measurement, power Doppler sonography, and proper blood testing to discriminate between Graves disease and painless thyroiditis. Based on the power Doppler sonographic findings, they were divided into 4 groups: from pattern 0 (most hypovascular thyroid) to pattern III (most hypervascular thyroid). Comparisons of multiple thyroid parameters were made among the groups.
  
  
  RESULTS
  The prevalence of Graves disease with pattern 0 (n = 27) was 13.9% among the patients with Graves disease. The sonographic and laboratory data for patients with Graves disease and pattern 0 were compared to those of the 21 patients with painless thyroiditis, which typically shows intrathyroid hypovascularity. Free triiodothyronine and thyroxine levels and the superior thyroid artery PSV were significantly lower in patients with Graves disease and pattern 0 than those with patterns I, II, and III (P < .05). The thyroid volume and thyrotropin receptor antibody level were significantly lower in patients with Graves disease and pattern 0 than those with pattern III. In the comparison between patients with Graves disease and pattern 0 and those with painless thyroiditis and pattern 0, apart from thyrotropin receptor antibody, only the superior thyroid artery PSV was different.
  
  
  CONCLUSIONS
  Although the clinical features of patients with Graves disease and intrathyroid hypovascularity were similar to those patients with painless thyroiditis, the superior thyroid artery PSV showed a moderate ability to discriminate these patients.
authors.affiliation: Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan. uchitoyo@juntendo.ac.jp.
authors.forename: Toyoyoshi
authors.initials: T
authors.lastname: Uchida
authors.affiliation: Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
authors.forename: Nayumi
authors.initials: N
authors.lastname: Shigihara
authors.affiliation: Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
authors.forename: Kageumi
authors.initials: K
authors.lastname: Takeno
authors.affiliation: Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Komiya
authors.affiliation: Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Goto
authors.affiliation: Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Abe
authors.affiliation: Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Sato
authors.affiliation: Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Honda
authors.affiliation: Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Fujitani
authors.affiliation: Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Watada
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity; D003937:Diagnosis, Differential; D005260:Female; D006111:Graves Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012039:Regional Blood Flow; D013960:Thyroid Function Tests; D013961:Thyroid Gland / Q000098:blood supply* / Q000000981:diagnostic imaging; D013966:Thyroiditis / Q000000981:diagnostic imaging* / Q000453:epidemiology; D018608:Ultrasonography, Doppler
keywords: Graves disease; intrathyroid vascularity; painless thyroiditis; power Doppler sonography; superficial structures