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 cm(3) vs 12.1 +/- 2.4 cm(3); 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. (C) 2008 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.