穂積 康夫¹, 山中 桓夫², 葛谷 信明², 島貫 公義¹, 秋池 功³, 井上 裕美子³, 宮田 道夫¹

Yasuo HOZUMI¹, Takeo YAMANAKA², Nobuaki KUZUYA², Kimiyoshi SHIMANUKI¹, Isao AKIIKE³, Yumiko INOUE³, Michio MIYATA¹

¹自治医科大学大宮医療センター外科, ²自治医科大学大宮医療センター内科, ³自治医科大学大宮医療センター生理機能超音波室

¹Departments of Surgery, Omiya Medical Center, Jichi Medical School, ²Departments of Internal Medicine, Omiya Medical Center, Jichi Medical School, ³Section of Ultrasound, Omiya Medical Center, Jichi Medical School

キーワード : Color flow mapping, Diffuse goiter, Pulsed Doppler, Superior thyroid artery

In order to make precise differential diagnosis of diffuse goiter without nodular lesions (Graves' disease and chronic thyroiditis), we used conventional and Doppler ultrasonography (Toshiba Model SSA-270 A, with a 7.5 MHz transducer) to examine 173 patients with diffuse goiter. Images showing markedly increased intrathyroidal blood flow were obtained in 72% of cases of active Graves' disease. Peak velocity in the superior thyroid arteries of patients with active hyperthyroidism was significantly greater than that in patients with hyperthyroidism in the euthyroid state and all cases of thyroiditis. We conclude that, despite its simplicity, color Doppler ultrasonography is useful in the differential diagnosis of diffuse goiter. Using it in combination with the measurement of velocity in the superior thyroid artery makes diagnosis even easier.