Evaluation of thyrotoxicosis during pregnancy with color flow Doppler sonography

Objective: To determine whether color flow Doppler sonography (CFDS) is useful in differentiating Graves vs non-Graves thyrotoxicosis during pregnancy, when nuclear imaging is contraindicated. Methods: Ten pregnant women with thyrotoxicosis were divided into Graves, and non-Graves, disease groups and were evaluated by CFDS for thyroid volume, vascularity, and inferior thyroid artery (ITA) flow velocity. Each patient was matched with a euthyroid woman of the same pregnancy duration. Results: Of the 10 patients, 3 were diagnosed with Graves disease, 4 with gestational toxicosis, and 3 with destructive thyroiditis. Those in the Graves disease group had a greater thyroid gland volume (18.9 ± 1.5 cm3 vs 12.1 ± 2.4 cm3; P < 0.05), greater thyroid vascularity, and greater ITA flow velocity than those in the non-Graves disease group (92 ± 13 cm/s vs 20.4 ± 2.4 cm/s; P < 0.05). There was no significant difference in the corresponding values between the patients with gestational toxicosis and those with destructive thyroiditis or between them and their healthy controls. Conclusion: Thyroid evaluation by CFDS is useful for the differential diagnosis of thyrotoxicosis in pregnant women.