Association Between Some Ultrasound Parameters and TSH-Receptor Antibodies
Author: Stoynova, Mariya A., Shinkov, Alexander D., Kovatcheva, Roussanka D.
Abstract:
Introduction: Graves’ disease is an autoimmune disorder and both ultrasound examination and determination of TSH receptor antibodies (TRAb) play an important role in its diagnosis. TRAb levels are also relevant to the prognosis of the disease – their negativization in the course of antithyroid drug therapy is associated with lower risk of relapses.
Aim: The aim of this study is to investigate the association between some ultrasound parameters and TRAb levels in patients with Graves’ disease.
Material and methods: The study included 66 patients (52 women, 14 men) with Graves’ disease on antithyroid drugs of mean age 49,5 years (23-79 years) and disease duration of 19,5 months (4-58 months). The patients were divided into two groups: Group 1 – with positive TRAb (n=34); Group 2 – with negative TRAb (n=32). TSH, FT4, TRAb were examined in all patients and thyroid ultrasound was performed to determine the volume, echogenicity, parenchymal blood flow and nodularity of the thyroid gland.
Results: Thyroid volume was significantly higher in Group 1 patients (15 ml vs 10,5 ml, p=0,047). Among them marked hypoechogenicity (p=0,047) and increased blood flow (p<0,001) were found significantly more frequently. The incidence of thyroid nodules in Group 1 was 35%, while in Group 2 it was 44% (p=0,62).
Conclusion: Enlarged thyroid volume, increased blood flow and marked hypoechogenicity are more common in patients with Graves’ disease and together with persistent immunological activity appear to be negative prognostic factors for achieving immunologic remission.
Key words: Graves’ disease, TSH-receptor antibodies (TRAb), thyroid volume, blood flow, echogenicity.
