Role of color Doppler in differentiation of Graves' disease and thyroiditis in thyrotoxicosis

Figure 1 Gray scale ultrasound, color Doppler, Doppler spectral analysis in patients with Graves’ disease. A: Gray scale ultrasound of the right lobe of the thyroid gland in patients with Graves’ disease shows enlarged gland with smooth contour and heterogeneous echotexture; B: Color Doppler of the same patient shows diffuse increase vascularity of the thyroid gland; C: Doppler spectral analysis of the right inferior thyroid artery of the same patients show elevated peak systolic velocity (V₁ = 89.8 cm/s) and elevated end diastolic velocity (V₂ = 44.9 cm/s). CCA: Common carotid artery; IJV: Internal jugular vein; IJV: Internal jugular vein.

Figure 2 Thyroid scintigraphy of the same patient showed enlarged both lobes of the thyroid with diffuse increase uptake. R: Right; Tc99m: Technetium TC 99M pyrophosphate.

Figure 3 Receiver operating characteristic analysis of the results determined that 40 cm/s is the appropriate cut-off value of peak systolic velocity to differentiate Graves’ disease from thyroiditis. ROC: Receiver operating characteristic.