Right lobe, transverse scan

Right lobe, longitudinal scan

Right lobe, color Doppler mode

Right lobe, microflow imaging

Left lobe, transverse scan

Left lobe, longitudinal scan

Left lobe, color Doppler mode

Left lobe, microflow imaging

Clinical data: A 35-year-old woman was referred for a newly diagnosed hyperthyroidism. The patient had typical complaints, including elevated heart rate and weight loss.

Summary of ultrasound and laboratory data:

Date of examination	Volume of the thyroid lobes (mL)		Echogenicity index (%)	Therapy before	Results of laboratory investigations			Therapy after
	Right lobe	Left lobe			TSH (mIU/L)	FT4 (pM/L)	FT3 (pM/L)
First visit	27.2	18.4	70%	Nothing	< 0.001	61.2	35.7	30 mg methimazole
5 weeks after the first visit	19.1	13.5	50%	30 mg methimazole	< 0.001	7.85	6.19	15 mg methimazole
4 months after the first visit	10.4	14.4	20%	15 mg methimazole	0.06	13.7	4.61	10 mg methimazole
9 months after the first visit	13.9	12.0	10%	10 mg methimazole	1.98	8.11	-	5 mg methimazole
12 months after the first visit	10.1	11.3	< 10%	5 mg methimazole every other day	4.97	10.1	-	Nothing

 

Comment.

This is the typical course of a non-relapsing Graves' hyperthyroidism. As the hormone results improve, both the size of the initially enlarged goiter and the degree of hypoechogenicity decrease.