Discussion Of Curative Effect Evaluation Of¹³¹I Therapy For Graves Disease Using Thyroid Ultrasound Quantitative Indicators

Purpose:1.To observe the change of ultrasound parameters of radioactive131I treatment Graves disease in the early period (within7days after treatment).2. To test the accuracy of blood flow classification in thyroid parenchyma; and compare the correlation of blood flow classification、blood flow area ratio to FT3level.3. Compare the change of ultrasonic parameters and thyroid hormone level in different time points including before treatment,1months、3months and6months afteer131I treatment for Graves disease.4. Curative effect can be divided into clinical cue group and not cure groups, and to discuss the factors which affect the curative effect of131I treatment by facter analysis.5. To discuss the influence and the forecast of ultrasonic index and other observe factors before treatment for curative effect.6.To discuss the correlation of ultrasonic indexs6months after treatment for curative effect.Method:1.35patients diagnosed with Graves disease first recieve radioactive131I treatment, they all stoped food which containing excess iodine and anti-thyroid drugs. According to131I therapeutical procedure,the followings are carried out:regular physical examination, serological examination, effective half-life test,ultrasonic estimation of thyroid weight;color doppler flow imaging (CDFI):thyroid blood flow classification and blood flow area ratio(BCR); frequency spectrum doppler (PW) test of right lobe thyroid artery systolic peak flow velocity (PSV), diastolic peak velocity (EDV), mean velocity (Vmean), systolic acceleration time (SAT), time average velocity (TAVM), resistance index (RI), pulse index (PI) and PSV×HR, per minute blood flow (Q).Then determine131I dose and give one-time.2.The ultrasonic index shoude be tested within7days after treatment; ultrasonic index would be tested1,3,6months after treatment and serological examination shoud be proceed at the same time.3.Sort of the follow-up data and statistical analysis them.Results:Ultrasonic indicators in the early time of radioactive131I treatment for Graves disease have no significant change (P＞0.05).2.Blood flow classification of thyroid parenchyma obviously associated with thyroid blood flow area (r=0.838, P=0.000); the two parameters correlate with FT3level before the treatment (r=0.271, P=0.021; r=0.334, P=0.009),3months after treatment (r=0.417, P=0.034; r=0.328, P=0.328),6months after treatment (r=0.603, P=0.603; r=0.484, P=0.484).3. In different time points(before treatment,1months、3months and6months)of131I treatment for Graves disease, the significant changed indicators of ultrasonic parameters and thyroid hormone include thyroid weight, PSV, EDV, Vmean, PSV×HR,FT3,FT4,TSH(F=12.06,4.54,3.45,4.74,3.50,22.83,12.78,2.89, P＜0.05)。4.Using factor analysis, to extract six common factors,the first common factor explanation for thyroid artery blood flow velocity relevanted parameters; The second common factor explanation for blood flow distribution in the thyroid parenchyma; The third common factor explanation for131I doses; the forth common factor defined as thyroid artery vascular index; the fifth common factor interpreted as general situation; the sixth common factor interpreted as the related time factor.5.131I treatment for Graves disease total effective rate reached100%in this study. Observe factors before treatment which influence the curative effect inchude thyroid artery blood flow velocity relevanted indicators:PSV, EDV, Vmean, TAVM, PSV x HR; thyroid gland weight; blood flow classification and blood flow area ratio; thyroid artery diameter and131I doses. The above indicaters have negative correlation with curative effect.6. Ultrasonic indicators six months after treatment which influence the curative effect inchude thyroid artery blood flow velocity relevanted indicators:PSV, EDV, Vmean, TAVM, PSV×HR, Q; thyroid gland weight; blood flow classification and blood flow area ratio;thyroid artery diameter. The above indicaters have negative correlation with curative effect.Conclusion:In the process of131I treatment and recovery for Graves disease, two-dimensional ultrasound and part of doppler blood flow indicator have good effect on evaluation and prediction for131I treatment for Graves disease.