Endocrine Abstracts

Background: The purpose of this study was to measure the ability of Microvascular ultrasonography (MVUS), which is a third-generation Doppler technique developed to increase sensitivity, to distinguish Graves’ disease (GD) from destructive thyroiditis (DT).

Methods: This prospective study included a total of 167 patients from October 2020 to January 2023. Of them, 85 were patient with GD. All ultrasonography examinations were performed using microvascular flow technology (MV-Flow^TM). In the middle of study, there was a software upgrade of the ultrasound machine. The analysis was conducted before (cohort 1, 99 people, Graves 47) and after (cohort2, 68 people, Graves 38) the upgrade and for entire population. The color and power Doppler (CD and PD), and MVUS images were semi-quantitatively graded according to blood flow patterns. On the MVUS images, vascularity indices (VIs), which were the ratio (%) of color pixels in the total grayscale pixels in a defined region of interest, were obtained automatically. Receiver-operating characteristic curve analysis was performed to verify the diagnostic performance of MVUS.

Results: The area under the curve (AUC) for CD, PD, MVUS and MVUS-VI was 0.785, 0.824, 0.820 and 0.852 respectively for entire population. The optimal cutoff value of the MVUS-VI was 27.35% for distinguishing GD and DT with 81.2% sensitivity and 82.9% specificity. For cohort 1, the AUC of MVUS-VI was 0.815 and for cohor2, was 0.821.

Conclusion: In a real time and quantitative manner, MVUS-VI could be helpful to differentiate GD from thyroiditis in thyrotoxic patients, compared to conventional Doppler images.