Endocrine Abstracts

Objective: This study investigates the effectiveness and additional value of contrast-enhanced ultrasound (CEUS) in differentiating between destructive thyroiditis and hyperproduction states in patients with diffuse thyroid disease.

Methods: In this research, 56 patients diagnosed with hyperthyroid diffuse disease underwent evaluation through CEUS, alongside conventional ultrasound and standard diagnostic tests. We focused on qualitative CEUS parameters like perfusion patterns, enhancement intensity, and washout timing, comparing these between the two patient groups: those with destructive thyroiditis and those with hyperproduction-induced hyperthyroidism.

Results: Initial findings revealed distinct CEUS perfusion patterns differentiating between the two conditions. Destructive thyroiditis was characterized by slow wash-in with peak enhancement at median 18s (16-22s) and swift washout median 30s seconds (28-36s), indicative of increased vascular permeability and inflammation. Conversely, hyperproduction states displayed fast wash-in - median 10s (8-12.5s) (P = 0.01) and prolonged enhancement, suggesting enhanced thyroid activity and vascularity. CEUS showed high diagnostic accuracy (AUC 0.905) with sensitivity at 91% and specificity at 88.3%. These findings were in alignment with biochemical markers, suggesting the potential of CEUS in augmenting diagnostic accuracy.

Conclusion: CEUS contributes significantly to a deeper imaging-based understanding of pathophysiological differences in hyperthyroid diffuse diseases, aiding in more informed diagnostic and therapeutic decisions.