Prediction Of The Effect Of ¹³¹? Therapy For Graves Disease By Three-dimensional Power Doppler Angiography And Serum Vascular Endothelial Growth Factor

Objectives To investigate the relationship between the parameters of thyroid and the effect of 131 I therapy for Graves disease,to provide the clinical objective indexes.These parameters including the quantitative indexs of three dimensional power Doppler angiography(MG,VI,FI,VFI)and the expression of vascular endothelial growth factor(VEGF).Methods From August 2015 to June 2016,54 patients with Graves disease who visited to the Department of nuclear medicine in our hospital outpatient,and diagnosed by clinical and laboratory examination were selected.At the same time,30 healthy people were selected as normal control group.All patients received 131 I treatment,and measured the following parameters before 131 I treatment and 6 months after treatment:two-dimensional color Doppler ultrasound(CDFI)measurement of thyroid artery blood flow(STA-PSV),3D-PDA examination to obtain quantitative parameters MG,VI,FI,VFI,simultaneous determination of FT3,FT4,TSH and 24h-radioactive iodine uptake,at last,the serum VEGF concentration was measured.According to the FT3,FT4 and TSH after 6 months treatment,to evaluate the curative effect,the patients were divided into four groups: invalid or relapse group(n = 3),partial remission group(n = 9),complete remission group(n = 28),and hypothyroidism group(n = 14).Statistical analysis of the above parameters.Results1.Ultrasound indexes VI,FI,VFI and serum VEGF concentration of case group before treatment were higher than that in normal group(P < 0.01),and after treatment were lower than those before treatment(P < 0.01);at the same time,these parameters showed a decreasing trend in the four groups of the invalid or relapse group,partial remission group,complete remission group and hypothyroidism group,the difference was statistically significant(P < 0.01).3.Pearspn correlation analysis showed:(1)3D-PDA quantitative indicators VI,FI and VFI before treatment were positively correlated with the index of CDFI(STA-PSA)(r=0.407?0.497?0.433,P<0.01);(2)The serum VEGF concentration before treatment was positively correlated with VI,FI and VFI(r=0.644?0.521?0.634,P< 0.05),and no significant correlation was found with MG(P > 0.05);(3)The ultrasound indexes VI,FI,VFI and serum VEGF concentrations before treatment were positively correlated with FT3(r=0.317?0.305?0.336?0.315,P<0.05),while had no significant correlation with TSH(P > 0.05),at the same time,FI,VFI and 24 hrate of iodine uptake was positively correlated(r=0.301?0.311,P<0.05),and MG was not significantly correlated with the FT3?TSH and 24h-RAIU(P > 0.05).4.Before treatment,VI,FI,VFI and serum VEGF concentration were negatively correlated with curative effect(P < 0.01).Conclusions1.3D-PDA parameters VI,FI,VFI and serum VEGF concentration can quantitatively evaluate the function of thyroid gland.2.Three-dimensional ultrasound can be used as a useful supplement of two-dimensional ultrasound,and can indirectly reflect the level of thyroid hormone and radioactive iodine uptake.At the same time,it can provide effective imaging information for the diagnosis of Graves disease,the severity of the disease and the evaluation and follow-up of the therapeutic effect.3.VI,FI,VFI and serum VEGF concentration can be used to evaluate the prognosis of 131 I treatment of Graves disease,these indicators with VI,FI,VFI predict the better curative effect.