Mean Peak Systolic Velocity Of Superior Thyroid Artery For The Differential Diagnosis Of Thyrotoxicosis:A Diagnostic Meta-analysis

Objective: Thyrotoxicosis is often caused by Graves’ disease(GD)or destructive thyroiditis(DT),and a prompt and accurate differential diagnosis for thyrotoxicosis is needed as management strategy differs.We performed a meta-analysis of published literature to evaluate the diagnostic accuracy for differentiating GD from DT patients by measurement of mean peak systolic velocity of superior thyroid artery(STA-PSV)using ultrasonography.Methods: The databases of Pubmed,Embase,Web of Science,Cochrane,Wanfang,and CNKI were retrieved without time limit to identify eligible studies.The statistical information and scientific quality were assessed and classified.The data were analyzed using Stata12.0 software.We comprehensively evaluate the accuracy of STA-PSV by ultrasonography in distinguishing GD from DT through the pooled sensitivity,specificity,positive likelihood ratio(PLR),negative likelihood ratio(PLR),diagnostic odds ratio(DOR),the symmetric receiver operating characteristic curve(SROC)and other indicators.Results: A total of 11 studies with 1052 cases only from Asia were included.Meta-analysis results showed the pooled sensitivity and pooled specificity of STA-PSV in distinguishing GD from DT by ultrasonography were 0.86(95% CI,0.80-0.90)and 0.93(95% CI,0.86-0.97),respectively.The results showed PLR and NLR of STA-PSV in differentiating GD from DT patients were 13.0(95% CI,6.1-27.8)and 0.15(95% CI,0.10-0.22),respectively.In addition,the mean DOR value of STA-PSV was 85(95% CI,33-220),with the area under the SROC was0.94(95% CI,0.92-0.96).Conclusions: STA-PSV by ultrasonography has a better diagnostic accuracy in the differentiation of GD from DT in the included studies.More studies from other countries are needed to further evaluate the accuracy of STA-PSV for the differential diagnosis of thyrotoxicosis.