PDF(Pubmed)
Abstract：
Hyperthyroidismis a prevalent condition affecting global populations, with an overall prevalence of 1.2%. Our research aimed to establish a systematic diagnostic approach using multiparametric ultrasound (MPUS) to diagnose hyperthyroid diffuse thyroid disease (DTD).
We conducted a retrospective study from June 2021 to June 2023 at a specialized endocrinology center in Timisoara, Romania, enrolling subjects presenting with clinical hyperthyroidism. Using the Mach 30 Aixplorer ultrasound equipment, evaluations were performed initially in B-mode US, followed by Color Doppler and Spectral Doppler measurements, and finally, 2D Shear wave elastography (SWE).
From the 218 patients analyzed, the diagnosis of DTD with hyperthyroidism was confirmed through biochemical assessment, subgrouping various pathologies such as subacute thyroiditis, Graves\' disease, painless thyroiditis, Hashimoto\'s thyroiditis, iatrogenic, as well as healthy controls. In the first step, B-mode hypoechogenicity had an AUC of 0.951 for DTD detection. In the second step, the peak systolic velocity differentiated Graves\' disease with a median of 42.4 cm/s and an AUC of 1. Lastly, the third step consisted of SWE evaluation, revealing a mean elasticity index in the SAT subgroup significantly higher from other subgroups (p<0.001) with an AUC of 1.
Our study offers a step-by-step evaluation algorithm for DTD diagnosis, with a very good overall diagnostic performance (AUC of 0.946).
We conducted a retrospective study from June 2021 to June 2023 at a specialized endocrinology center in Timisoara, Romania, enrolling subjects presenting with clinical hyperthyroidism. Using the Mach 30 Aixplorer ultrasound equipment, evaluations were performed initially in B-mode US, followed by Color Doppler and Spectral Doppler measurements, and finally, 2D Shear wave elastography (SWE).
From the 218 patients analyzed, the diagnosis of DTD with hyperthyroidism was confirmed through biochemical assessment, subgrouping various pathologies such as subacute thyroiditis, Graves\' disease, painless thyroiditis, Hashimoto\'s thyroiditis, iatrogenic, as well as healthy controls. In the first step, B-mode hypoechogenicity had an AUC of 0.951 for DTD detection. In the second step, the peak systolic velocity differentiated Graves\' disease with a median of 42.4 cm/s and an AUC of 1. Lastly, the third step consisted of SWE evaluation, revealing a mean elasticity index in the SAT subgroup significantly higher from other subgroups (p<0.001) with an AUC of 1.
Our study offers a step-by-step evaluation algorithm for DTD diagnosis, with a very good overall diagnostic performance (AUC of 0.946).
摘要：
■甲状腺机能亢进是影响全球人口的一种普遍疾病，总体患病率为1.2%。我们的研究旨在建立使用多参数超声（MPUS）诊断甲状腺功能亢进弥漫性甲状腺疾病（DTD）的系统诊断方法。
■我们从2021年6月至2023年6月在蒂米什瓦拉的一个专门的内分泌中心进行了一项回顾性研究，罗马尼亚,招募表现为临床甲状腺功能亢进的受试者。使用30马赫Aixfrer超声设备，最初在B型US中进行评估，其次是彩色多普勒和频谱多普勒测量，最后，二维剪切波弹性成像(SWE)。
■从分析的218名患者中，通过生化评估证实了DTD与甲状腺功能亢进的诊断，亚急性甲状腺炎等各种病理分组，严重的疾病，无痛性甲状腺炎,桥本甲状腺炎,医源性,以及健康的控制。第一步,B型低回声性对于DTD检测具有0.951的AUC。第二步,收缩期峰值速度区分Graves病，中位数为42.4cm/s，AUC为1。最后,第三步包括SWE评估，显示SAT亚组的平均弹性指数明显高于其他亚组（p<0.001），AUC为1。
■我们的研究提供了DTD诊断的逐步评估算法，具有非常好的整体诊断性能（AUC为0.946）。
■我们从2021年6月至2023年6月在蒂米什瓦拉的一个专门的内分泌中心进行了一项回顾性研究，罗马尼亚,招募表现为临床甲状腺功能亢进的受试者。使用30马赫Aixfrer超声设备，最初在B型US中进行评估，其次是彩色多普勒和频谱多普勒测量，最后，二维剪切波弹性成像(SWE)。
■从分析的218名患者中，通过生化评估证实了DTD与甲状腺功能亢进的诊断，亚急性甲状腺炎等各种病理分组，严重的疾病，无痛性甲状腺炎,桥本甲状腺炎,医源性,以及健康的控制。第一步,B型低回声性对于DTD检测具有0.951的AUC。第二步,收缩期峰值速度区分Graves病，中位数为42.4cm/s，AUC为1。最后,第三步包括SWE评估，显示SAT亚组的平均弹性指数明显高于其他亚组（p<0.001），AUC为1。
■我们的研究提供了DTD诊断的逐步评估算法，具有非常好的整体诊断性能（AUC为0.946）。
