Color Duplex Doppler US can Follow up the Response of Radioiodine in Graves’ Disease by Evaluating the Thyroid Volume and Peak Systolic Velocity

Thiago Adler Ralho Rodrigues Santos; Suemi Marui; Tomoco Watanabe; Nicolau Lima; Claudia Okanobo Ozaki; Giovanni Guido Cerri; Maria C. Chammas

doi:10.1055/a-0902-4842

Ultraschall in der Medizin - European Journal of Ultrasound, Inhaltsverzeichnis

Ultraschall Med 2020; 41(06): 658-667
DOI: 10.1055/a-0902-4842

Original Article

Color Duplex Doppler US can Follow up the Response of Radioiodine in Graves’ Disease by Evaluating the Thyroid Volume and Peak Systolic Velocity

Farbduplex-Doppler-US kann das Ansprechen auf Radiojodtherapie bei Morbus Basedow mittels Schilddrüsenvolumen und maximaler systolischer Geschwindigkeit bewerten

Thiago Adler Ralho Rodrigues Santos

¹Radiology Institute, Clinical Hospital of the Medical School of the University of São Paulo, Sao Paulo, Brazil

,

Suemi Marui

²Laboratory of Cellular and Molecular Endocrinology (LIM 25), Clinical Hospital of the Medical School of the University of São Paulo, Sao Paulo, Brazil

,

Tomoco Watanabe

¹Radiology Institute, Clinical Hospital of the Medical School of the University of São Paulo, Sao Paulo, Brazil

,

Nicolau Lima

³Endocrinology Institute, Clinical Hospital of the Medical School of the University of São Paulo, Sao Paulo, Brazil

,

Claudia Okanobo Ozaki

⁴Nuclear-Medicine, SONIMED diagnostic medicine, Campo Grande, Brazil

,

Giovanni Guido Cerri

¹Radiology Institute, Clinical Hospital of the Medical School of the University of São Paulo, Sao Paulo, Brazil

,

Maria C. Chammas

¹Radiology Institute, Clinical Hospital of the Medical School of the University of São Paulo, Sao Paulo, Brazil

› Institutsangaben

Abstract

Purpose The objective of this study was to prove the efficacy of Doppler ultrasonography (US-Doppler) in the follow-up of patients with GD treated with radioactive iodine.

Methods 97 patients (77 female and 20 male) with a mean age of 42 years (SD ± 15) and with prior diagnosis of GD were treated with radioiodine. In total, 88.5 % achieved euthyroidism or hypothyroidism after treatment. The study was documented before treatment and one, three, and six months after treatment with radioactive iodine (131I) by a single investigator. The volume, echogenicity, echotexture and vascularization of the glands as well as the peak systolic velocity (PSV) of the inferior thyroid arteries were evaluated and compared with the laboratory data.

Results Thyroid volume and PSV had a statistically significant correlation with hormone levels (p < 0.05). The mean pre-dose therapeutic thyroid volume was 43.01 ± 3.88 cm³ and was 11.58 ± 11.26 cm³ 6 months after treatment. The mean PSV before 131I was 90.06 ± 44.13 cm/s and decreased significantly over time (p < 0.001). Six months after the therapeutic dose, the mean PSV was 32.95 ± 16.36 cm/s. However, the subjective parameters did not have a significant correlation with the normalization of the thyroid hormones.

Conclusion Doppler US was useful for monitoring the therapeutic response of GD patients after treatment with radioiodine by evaluating the thyroid volume and peak systolic velocity.

Zusammenfassung

Ziel Das Ziel dieser Studie war es, die Leistungsfähigkeit der Dopplersonografie (US-Doppler) in der Nachbeobachtung von Patienten mit Morbus Basedow nach Radiojodtherapie zu überprüfen.

Material und Methoden 97 Patienten (77 Frauen und 20 Männer) mit einem Durchschnittsalter von 42 Jahren (SD ± 15) und Diagnose eines Morbus Basedow erhielten eine Radiojodtherapie. Insgesamt kam es bei 88,5 % nach der Behandlung zu einer Euthyreose oder Hypothyreose. Die Studie wurde vor Behandlung sowie 1, 3 und 6 Monate nach Radiojodtherapie (131I) durch einen einzelnen Untersucher dokumentiert. Das Volumen, die Echogenität, die Echotextur und die Vaskularisation der Drüsen sowie die maximale systolische Geschwindigkeit (PSV) der A. thyreoidea inferior wurden bewertet und mit den Laborergebnissen verglichen.

Ergebnisse Schilddrüsenvolumen und PSV zeigten eine statistisch signifikante Korrelation mit den Hormonspiegeln (p < 0,05). Das mittlere therapeutische Schilddrüsenvolumen vor Therapie betrug 43,01 ± 3,88 cm³ und lag 6 Monate nach Behandlung bei 11,58 ± 11,26 cm³. Die mittlere PSV vor Gabe von 131I betrug 90,06 ± 44,13 cm/s und nahm im zeitlichen Verlauf signifikant ab (p < 0,001). 6 Monate nach Therapie betrug die mittlere PSV 32,95 ± 16,36 cm/s. Es gab jedoch keinen signifikanten Zusammenhang zwischen den subjektiven Parametern und der Normalisierung der Schilddrüsenhormone.

Schlussfolgerung Doppler-US zeigte sich für die Bewertung des Schilddrüsenvolumens und der maximalen systolischen Geschwindigkeit bei der Überwachung des therapeutischen Ansprechens von Morbus-Basedow-Patienten auf die Radiojodtherapie von Nutzen.

Key words

thyroid gland - hyperthyroidism - Graves’ disease - duplex-doppler ultrasound - radioiodine therapy (131I)

Volltext

Referenzen

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