Thesis (Ph. D.)--University of Washington, 2008. / Vita. Includes bibliographical references (leaves 361-374).

Orientador: Maria Emilia Franco Oliveira / Resumo: O presente estudo testou a hipótese de que a hCG e pFSH estimulam o desenvolvimento folicular e de corpos lúteos, equivalente aos induzidos pela eCG em fêmeas caprinas. Cento e quinze cabras Toggenburg foram dividas e submetidas ao protocolo de curta duração (60 mg MAP, 6 dias; Dia - 8) durante o período sazonal de transição. Cada grupo recebeu 24 hs antes da remoção da esponja 22.5 µg d – cloprostenol e 200 UI eCG, ou 300 UI hCG ou 30 UI pFSH. A dinâmica folicular (n = 85 cabras) foi realizada desde o momento da aplicação da gonadotrofina (Dia – 3) até a detecção da ovulação. O início do estro (Dia 0) foi monitorada para avalição do comportamento estral. As variáveis biométricas e vasculares do corpo lúteo (CL: área, diâmetro, volume, ecogeneidade, heterogeneidade, escore de vascularização e número de pixels coloridos) entre cabras prenhes e não prenhes foram avaliadas em momentos específicos (Dia 5, 8, 13, 18, 23 e 28) pela ultrassonografia bidimensional (Modo B) e Doppler Colorido. O diagnóstico de gestação foi confirmado pela detecção da vesícula embrionária, realizada sobre o Dia 28. O diâmetro do maior folículo no dia da aplicação da gonadotrofina e o tempo para o alcance do diâmetro máximo do folículo dominante foi maior e mais precoce no grupo eCG (P = 0,024 e P = 0,002; respectivamente). Cabras tratadas com eCG e pFSH apresentaram maiores dimensões foliculares (P = 0,003) e hCG, maior número de folículos ovulatórios (P = 0,004) e corpos lúteos (P = 0,0001). A ovulaçã... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The present study tested the hypothesis that hCG and pFSH stimulate follicular and corpora lutea growth, equivalent to those induced by the eCG in goat females. Toggenburg goats (n = 115) were divided and submitted to the short duration protocol (60 mg MAP, 6 days; Day – 8) during the seasonal transition period. Each group received 22.5 µg d – cloprostenol and 200 IU eCG, or 300 IU hCG or 30 UI pFSH, 24 hours before the sponge removal. The follicular dynamics (n = 85 goats) were performed from the moment of the application of gonadotropin (Day - 3) until the detection of ovulation. The onset of estrus (Day 0) was monitored for evaluation of estrus behavior. The biometric and vascular variables of the corpus luteum (CL: area, diameter, volume, ecogeneity, heterogeneity, vascularization score and number of colored pixels) between pregnant and non-pregnant goats were evaluated at specific times (Day 5, 8, 13, 18, 23 and 28) by two-dimensional ultrasound (Mode B) and Color Doppler. The pregnancy diagnosis was confirmed by detection of the embryonic vesicle performed on Day 28. The diameter of the largest follicle on the day of application of gonadotrophin and the time to reach the maximum diameter of the dominant follicle was higher and earlier in the eCG group (P = 0.024 and P = 0.002, respectively). Goats treated with eCG and pFSH presented greater follicular dimensions (P = 0.003) and hCG, greater number of ovulatory follicles (P = 0.004) and corpora lutea (P = 0.0001). Ovulat... (Complete abstract click electronic access below) / Doutor

Made available in DSpace on 2014-06-11T19:26:18Z (GMT). No. of bitstreams: 0 Previous issue date: 2004Bitstream added on 2014-06-13T18:54:34Z : No. of bitstreams: 1 komatsu_my_me_botfm_prot.pdf: 2888253 bytes, checksum: 2a008d09d5316840782f66ef671ef847 (MD5) / Universidade Estadual Paulista (UNESP) / O aumento progressivo nas últimas décadas na incidência do câncer de mama é um fato que assola a humanidade, entretanto, as taxas de mortalidade tendem ao decréscimo em virtude da detecção precoce através de métodos de rastreio não invasivos, e do conhecimento cada vez maior do comportamento biológico do tumor. A maior adesão aos meios de rastreamento existentes hoje, deve-se não apenas ao medo que o câncer provoca nas mulheres, mas também ao fato dos exames utilizados para este rastreio não serem invasivos. Infelizmente, ainda não existem métodos capazes de dar indícios do comportamento biológico do tumor de forma instantânea, sem que haja a necessidade de submeter as pacientes portadoras de tumores malignos da mama a procedimentos cirúrgicos. Desde o início da última década do século XX, tem-se estudado a angiogênese do tumor através da ultra-sonografia, utilizando-se dos recursos de Color Doppler e Power Doppler. Neste trabalho, realizado no Hospital Santa Marcelina de Itaquaquecetuba, em conjunto com a Disciplina de Mastologia da Faculdade de Medicina de Botucatu - UNESP, foram estudadas trinta e cinco pacientes com tumores malignos da mama, onde os parâmetros hemodinâmicos (Índice de Resistência, Índice de Pulsatibilidade e a Velocidade Máxima no Pico Sistólico) através do Color Doppler... / Although a progressive increase in the incidence of breast cancer is a fact that plagues mankind, mortality rates tend to decrease given precocious detection using non-invasive tracking methods and an ever-growing knowledge of tumoral biological behaviour. The current large adhesion to tracking methods is explained not only by the fear cancer raises in women but also to the use of non-invasive exams. Unfortunately, there are no methods capable of giving instantaneous indication of tumoral biological behaviour without submitting patients with malignant tumors to surgical procedure. Since the early nineties and now at the dawn of the 21st Century, the angiogenesis of the tumor is being studied with the help of Color Doppler and Power Doppler ultrasonography. In this research - carried out at Santa Marcelina Hospital in Itaquaquecetuba in cooperation with the Department of Mastology of the Botucatu Medical School, São Paulo State University, thirty five patientes with mammary malignat tumors were... (Complete abstract click electronic access below)

TITLE: IN VIVO ANTRAL FOLLICLE WALL BIOPSY: A NEW RESEARCH TECHNIQUE TO STUDY OVARIAN FUNCTION USING THE HORSE AS A MODEL Abstract Understanding hormone and growth factor receptor expression in the follicular wall associated with the intrafollicular milieu and systemic endocrine aspects in vivo is crucial for a complete discovery of mechanisms behind folliculogenesis in different species. Furthermore, the comprehension of the interrelationships existent among the preovulatory follicle (POF) and corpus luteum (CL) diameter and blood flow, and progesterone (P4) production during different seasons of the year are warranted to optimize fertility in different species. In this dissertation, four studies in mares are presented with the following general objectives: (i) develop and validate a minimally invasive in vivo technique to obtain antral follicle wall biopsy (FWB) and follicular fluid (FF) samples simultaneously and repeatedly from the same individuals, during different stages of follicle development in different seasons of the year; (ii) use the FWB technique to elucidate and compare the expression pattern of different receptors and proteins involved in folliculogenesis and ovulatory mechanisms during different seasons of the year; and (iii) use B-mode and color Doppler ultrasonography techniques to characterize POF and CL diameter and blood flow during two transitional ovulatory seasons (spring and fall), and elucidate the interrelationships among these variables with systemic P4 concentration. In the first study (Chapter 2), two experiments were conducted; in Experiment 1 (ex vivo), a proof of concept study was developed to check the feasibility of using the biopsy forceps to harvest FWB samples. Ovaries of six slaughtered mares were used, and each follicle was sampled using two techniques: biopsy forceps and scalpel blade (control). In Experiment 2 (in vivo), FWB and FF samples from growing follicles during various developmental stages were harvested using a novel FWB transvaginal ultrasound-guided technique. In the second study (Chapter 3), antral follicle wall and FF samples were obtained from 10−, 20−, and 30−mm follicles during spring anovulatory (SAN) and spring ovulatory (SOV) seasons. Samples were collected in vivo from the same mares in both seasons, with the aims to study and compare the expression of proliferative, angiogenic, and pro-/anti-apoptotic receptors and proteins in the follicle wall among three follicle classes, and between the SAN and SOV seasons. In the third study (Chapter 4), FWB and FF samples were collected in vivo from dominant growing follicles during the SAN, SOV, summer (SU), and fall ovulatory (FOV) seasons, to study the expression patterns of different receptors and proteins involved in follicle development. In the fourth study (Chapter 5), the temporal relationships among diameter and blood flow of the POF and CL, and systemic P4 concentration during spring and fall transitional ovulatory seasons were studied. The main findings of the present studies were: (i) the histological appearance, organization, and thickness of the follicle wall layers (i.e. granulosa, theca interna, and theca externa) were not influenced by the harvesting techniques (biopsy forceps vs. scalpel blade); (ii) the overall recovery rates of FWB and FF samples were 97% and 100%, respectively. However, the success rate of obtaining samples with all layers of the follicle wall and clear FF varied according to follicle size; (iii) follicles of the SOV season had a higher expression of proliferative, angiogenesis, and anti-apoptotic proteins compared to the SAN season; (iv) follicles of the FOV season had lower expression of proliferative, angiogenesis, and luteinizing hormone receptors; and (v) positive correlations were observed among POF and CL parameters, and P4 concentration. In conclusion, results demonstrated that the novel in vivo FWB technique developed in this study can be repeatedly and simultaneously used to provide sufficient FWB and FF samples for various cellular and molecular studies without jeopardizing the ovarian function in mares. Furthermore, results presented herein showed that several proliferative, angiogenic, and pro-/anti-apoptotic proteins are differentially expressed within different layers of the antral follicle wall among different seasons of the year. Finally, results demonstrated that larger and well-vascularized POFs have the potential to produce larger CLs with greater blood flow, and subsequently greater P4 systemic levels.

H παρούσα μελέτη είχε σαν στόχο την μελέτη και τον προσδιορισμό των αιμοδυναμικών αλλαγών που συμβαίνουν στο ηπατικό παρέγχυμα με τη βοήθεια της απλής (Gray Scale Ultrasonography, GSU) και της έγχρωμης Doppler υπερηχοτομογραφίας (Color Doppler, CDU), στην διάρκεια της χρόνιας ηπατικής νόσου. Ο απώτερος σκοπός ήταν ο διαχωρισμός της χρόνιας νόσου του ήπατος από την αρχόμενη καλά αντιρροπούμενη κίρρωση σε ομάδα ασθενών με ένα καλά τεκμηριωμένο ιστολογικό profil. Για τον λόγο αυτό, έγινε προσπάθεια να απομονωθούν εκείνες οι GSU και CDU παράμετροι που με μεγάλη ακρίβεια διαχώριζαν τους ασθενείς με τη χρόνια ηπατίτιδα από αυτούς που έπασχαν από καλά αντιρροπούμενη κίρρωση αρχικού σταδίου (CIR). / To assess the value of gray scale (GS) and colour Doppler ultrasonography (CDU) in differentiating the progression of chronic viral hepatitis (CVH) and compensated liver cirrhosis (CIR).

An adequate vascular perfusion status is essential not only to maintain life, but to ensure the proper physiology of the different systems that form the animal’s body. Due to its role in the transport of oxygen and nutrients toward, and the removal of cellular waste products away from the body’s tissues, the circulatory system is responsible for the maintenance of body homeostasis. Production related functions in farm animals are not an exception, and directly depend on sufficient vascular physiology. In the past, the study of blood flow in large domestic species was restricted to highly invasive techniques. However, even when such techniques are the foundation for the actual understanding of vascular dynamics in these animals, their limited feasibility and potential impact over the normal vascular physiology represent significant limitations to these approaches. Recently, the development and application of non-invasive technologies (i.e., Doppler and B- mode ultrasound) to the area of animal sciences has provided the potential for the study of vascular dynamics while, the negative implications aforementioned are avoided. In our studies, these technologies were applied to assess the role of the circulatory system on different production related variables such as: temperament, reproduction, and milk production in the bovine. A tendency toward differences in jugular blood flow was associated with the temperament in beef calves in this study. Also, a significant increase in vasodilation in the uterine arteries of beef cows was found to be associated with a numerically higher reproductive efficiency (i.e., pregnancy rates). Moreover, an increase in blood flow towards the mammary gland in dairy cows was associated with administration of bovine somatotropin. In conclusion, B- mode and Doppler ultrasound resulted in tools able to reflect the essential role of an adequate vascular perfusion in the normal physiology and productive performance in the bovine. However, in real farm scenarios the feasibility of these techniques in large domestic species is limited. Therefore, further specialization of this instrument to the conditions existent in such farm scenarios are recommended to improve its feasibility and to significantly accelerate the rate of knowledge acquisition in this area.

INTRODUÇÃO: A varicocele é a dilatação das veias do plexo pampiniforme do testículo. A associação entre a varicocele e a infertilidade é diagnosticada em 20 a 40% dos homens inférteis. Atualmente, o estudo ultrassonográfico da varicocele é realizado com o paciente na posição supina antes e durante a realização de Valsalva, levando-se em consideração o diâmetro das veias (> 0,20cm), e a presença de refluxo maior que 1, segundo ao estudo Doppler espectral. OBJETIVO: A) Propor uma nova metodologia na avaliação ultrassonográfica da varicocele. B) Avaliar a concordância dos achados no exame ultrassonográfico com Doppler colorido dos vasos dos plexos pampiniformes e as alterações no espermograma na infertilidade masculina. C) Avaliar a correlação entre o diâmetro de um dos vasos dos plexos pampiniformes e as alterações no espermograma na infertilidade masculina. MÉTODOS: Foram examinados 266 pacientes, provenientes do setor de reprodução humana do Hospital das Clínicas da Universidade de São Paulo (HCUSP), por meio de duplex Doppler colorido, inicialmente com o paciente em decúbito dorsal e posteriormente, após 5 minutos de espera, na posição ortostática, realizando as medidas dos diâmetros transversais dos plexos pampiniforme nas duas posições, tanto em repouso como em Valsalva. Ao estudo pulsado foi considerado refluxo patológico apenas quando persistia por mais de 1 segundo, com uma velocidade superior que 2 cm/s. Estes pacientes também foram submetidos a analise seminal. RESULTADOS: Em relação à metodologia de realização do exame, observou-se aumento no diâmetro do plexo pampiniforme apenas com a variação da posição de cerca de 18% à direita e 5,9% à esquerda, bem como aumento na detecção do refluxo venoso na posição ortostática, de 23% à direita e 6,8% à esquerda. Observou-se também correlação direta entre as alterações no espermograma com o refluxo venoso, 65% à direita e 86% à esquerda, o mesmo não ocorrendo com o diâmetro do plexo pampiniforme. CONCLUSÕES: A) O exame de ultrassongrafia com Doppler colorido deve ser realizado na posição ortostática, após um período de latência de no mínimo cinco minutos, com condições ambientais confortáveis e manobra de esforço. B) Houve concordância significativa entre o refluxo venoso nos plexos pampiniformes e as alterações do espermograma. C) Não há correlação significativa entre o diâmetro de um dos vasos dos plexos pampiniformes e o espermograma / INTRODUCTION: Varicocele is the dilatation of the veins of the pampiniform plexus of the testicle. The association between varicocele and infertility is diagnosed in 20 to 40% of the infertile men. Currently, in the ultrasound study of varicocele, the diameter of the veins is carried through with the patient in the supine position, before and during the Valsalva maneuver, taking the diameter of the veins consideration (> 0,20cm), and a more than 1 second bigger presence of reflux according to spectral Doppler study. OBJECTIVE: A) To consider a new methodology in the ultrasonographic evaluation of varicocele. B) To evaluate the agreement of the findings in the colorful Doppler ultrasonographic examination of the pampiniform plexus vases with the alterations in the spermogram in masculine infertility. C) To evaluate the correlation between the diameter of one the pampiniform plexus vases and the alterations in the spermogram in the masculine infertility. METHODS: 266 patients from the reproduction sector human being of the Hospital of the Clinics of the University of São Paulo (HCUSP) had been examined, by means of colorful duplex-Doppler, initially with the patient in dorsal decubitus and later, after 5 minutes, in the orthostatic position, carrying through the transversal measures of the diameter of the pampiniform plexus in the two positions, in rest and in Valsalva. To the pulse study reflux was considered pathological only when persisted for more than 1 second, with speed superior to 2 cm/s. These patients were also submitted to seminal analysis. RESULTS: Regarding the methodology of accomplishment of the examination, an increase in the diameter of pampiniform plexus was noted only with the variation of the examination position, about 18% to the right and 5,9% to the left, as well as an increase in the detection of venous reflux in the orthostatic position, 23% to right and 6,8% to the left. It was also detected a correct correlation between variations in the spermogram and the venous reflux, 65% to the right and 86% to the left, the same not occurring with the diameter of pampiniform plexus. CONCLUSIONS: A) The colorful Doppler ultrasound examination must be carried through in the orthostatic position, after a period of latency of at least five minutes, with comfortable environement conditions and effort maneuver. B) A significant accordance between the pampiniform plexus venous reflux and the alterations of the spermogram. C) It does not have significant correlation between the diameter of one of the pampiniform plexus vases and the spermogram

INTRODUÇÃO: A varicocele é a dilatação das veias do plexo pampiniforme do testículo. A associação entre a varicocele e a infertilidade é diagnosticada em 20 a 40% dos homens inférteis. Atualmente, o estudo ultrassonográfico da varicocele é realizado com o paciente na posição supina antes e durante a realização de Valsalva, levando-se em consideração o diâmetro das veias (> 0,20cm), e a presença de refluxo maior que 1, segundo ao estudo Doppler espectral. OBJETIVO: A) Propor uma nova metodologia na avaliação ultrassonográfica da varicocele. B) Avaliar a concordância dos achados no exame ultrassonográfico com Doppler colorido dos vasos dos plexos pampiniformes e as alterações no espermograma na infertilidade masculina. C) Avaliar a correlação entre o diâmetro de um dos vasos dos plexos pampiniformes e as alterações no espermograma na infertilidade masculina. MÉTODOS: Foram examinados 266 pacientes, provenientes do setor de reprodução humana do Hospital das Clínicas da Universidade de São Paulo (HCUSP), por meio de duplex Doppler colorido, inicialmente com o paciente em decúbito dorsal e posteriormente, após 5 minutos de espera, na posição ortostática, realizando as medidas dos diâmetros transversais dos plexos pampiniforme nas duas posições, tanto em repouso como em Valsalva. Ao estudo pulsado foi considerado refluxo patológico apenas quando persistia por mais de 1 segundo, com uma velocidade superior que 2 cm/s. Estes pacientes também foram submetidos a analise seminal. RESULTADOS: Em relação à metodologia de realização do exame, observou-se aumento no diâmetro do plexo pampiniforme apenas com a variação da posição de cerca de 18% à direita e 5,9% à esquerda, bem como aumento na detecção do refluxo venoso na posição ortostática, de 23% à direita e 6,8% à esquerda. Observou-se também correlação direta entre as alterações no espermograma com o refluxo venoso, 65% à direita e 86% à esquerda, o mesmo não ocorrendo com o diâmetro do plexo pampiniforme. CONCLUSÕES: A) O exame de ultrassongrafia com Doppler colorido deve ser realizado na posição ortostática, após um período de latência de no mínimo cinco minutos, com condições ambientais confortáveis e manobra de esforço. B) Houve concordância significativa entre o refluxo venoso nos plexos pampiniformes e as alterações do espermograma. C) Não há correlação significativa entre o diâmetro de um dos vasos dos plexos pampiniformes e o espermograma / INTRODUCTION: Varicocele is the dilatation of the veins of the pampiniform plexus of the testicle. The association between varicocele and infertility is diagnosed in 20 to 40% of the infertile men. Currently, in the ultrasound study of varicocele, the diameter of the veins is carried through with the patient in the supine position, before and during the Valsalva maneuver, taking the diameter of the veins consideration (> 0,20cm), and a more than 1 second bigger presence of reflux according to spectral Doppler study. OBJECTIVE: A) To consider a new methodology in the ultrasonographic evaluation of varicocele. B) To evaluate the agreement of the findings in the colorful Doppler ultrasonographic examination of the pampiniform plexus vases with the alterations in the spermogram in masculine infertility. C) To evaluate the correlation between the diameter of one the pampiniform plexus vases and the alterations in the spermogram in the masculine infertility. METHODS: 266 patients from the reproduction sector human being of the Hospital of the Clinics of the University of São Paulo (HCUSP) had been examined, by means of colorful duplex-Doppler, initially with the patient in dorsal decubitus and later, after 5 minutes, in the orthostatic position, carrying through the transversal measures of the diameter of the pampiniform plexus in the two positions, in rest and in Valsalva. To the pulse study reflux was considered pathological only when persisted for more than 1 second, with speed superior to 2 cm/s. These patients were also submitted to seminal analysis. RESULTS: Regarding the methodology of accomplishment of the examination, an increase in the diameter of pampiniform plexus was noted only with the variation of the examination position, about 18% to the right and 5,9% to the left, as well as an increase in the detection of venous reflux in the orthostatic position, 23% to right and 6,8% to the left. It was also detected a correct correlation between variations in the spermogram and the venous reflux, 65% to the right and 86% to the left, the same not occurring with the diameter of pampiniform plexus. CONCLUSIONS: A) The colorful Doppler ultrasound examination must be carried through in the orthostatic position, after a period of latency of at least five minutes, with comfortable environement conditions and effort maneuver. B) A significant accordance between the pampiniform plexus venous reflux and the alterations of the spermogram. C) It does not have significant correlation between the diameter of one of the pampiniform plexus vases and the spermogram

No description available.

INTRODUÇÃO: A amiodarona pode causar tireotoxicose, principalmente em áreas geográficas onde a ingestão de iodo é insuficiente. Dois tipos distintos de tireotoxicose associada à amiodarona (TAA) podem ser encontrados: A) o tipo 1 - a doença é secundária à sobrecarga de iodo (fenômeno Jod-Basedow), geralmente encontrada em indivíduos com doença tireóidea preexistente, B) o tipo 2 - quando a tireotoxicose deve-se a uma tireoidite destrutiva, com ruptura folicular e liberação do conteúdo folicular. A distinção entre os dois tipos é fundamental para a conduta terapêutica. Este estudo transversal, realizado no Instituto de Radiologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo entre janeiro de 2004 a março de 2006, objetivou: A) Demonstrar a utilidade da densidade de pixéis coloridos (DPC), parâmetro objetivo obtido por meio de programa de computador, na distinção entre os dois tipos de TAA. B) Determinar os melhores critérios objetivos de distinção entre os dois tipos de TAA por meio da ultra-sonografia dúplex-Doppler colorido da tireóide. C) Conhecer o grau de concordância intra-observadores e interobservadores dos padrões subjetivos de vascularização do parênquima tireóideo. MÉTODOS: Foram examinadas 158 glândulas tireóideas por meio de dúplex-Doppler colorido. Após passagem pelos critérios de seleção, 137 indivíduos foram divididos em quatro grupos: Grupo N (n = 84), grupo A (n = 30), grupo I (n = 14) e grupo II (n = 9), compostos por indivíduos normais, eutireóideos em uso de amiodarona, pacientes com tireotoxicose tipos 1 e 2, respectivamente. Todos os indivíduos foram submetidos ao estudo dúplex-Doppler colorido da tireóide e testes laboratoriais. Os pacientes em tireotoxicose também realizaram captação de iodo radioativo em 24 horas. RESULTADOS: No grupo I, tanto a densidade de pixéis coloridos (DPC = 17,22 ± 20,81%) quanto as velocidades de pico sistólico nas artérias tireóideas superiores (VSTS = 38,54 ± 18,62 cm/s) e inferiores (VSTI = 35,35 ± 18,08 cm/s) foram maiores do que nos demais grupos (p < 0,05). As análises de concordância do padrão subjetivo de vascularização do parênquima tireóideo mostraram coeficientes kappa ponderado (kw) variando de 0,78 a 0,79 para intra-observadores e de 0,83 a 0,86 para interobservadores. CONCLUSÕES: A) A DPC tem, isoladamente, boa capacidade para distinguir os dois tipos de TAA. B) Os melhores critérios objetivos na distinção entre TAA tipos 1 e 2 são a DPC e as velocidades de pico sistólico nas artérias tireóideas. C) As análises subjetivas dos padrões de vascularização apresentam boa concordância tanto intra-observadores quanto interobservadores. / INTRODUCTION: Amiodarone can cause thyrotoxicosis, mainly in geographic insufficient iodine intake areas. Two different types of amiodarone-associated thyrotoxicosis can be found: A) type 1 - it occurs in patients with preexistent thyroid disease, such as goiter or autonomous nodule, and the iodine load associated with amiodarone triggers increased synthesis of thyroid hormones (Jod-Basedow fenomenon), B) type 2 - a destructive thyroiditis is found, characterized by follicular rupture and release of its content. In order to treat appropriately, the differentiation between the two types is crucial. This transversal study, carried through at the Institute of Radiology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo from January 2004 to March 2006, aimed to: A) demonstrate the utility of the color pixel density (CPD), a semiquantitative parameter gotten by means of computer program, in the differentiation between the two types of AAT, B) verify the best objective criteria of distinction between the two types of AAT through the duplex-Doppler sonography of the thyroid, C) investigate the agreement intra and interobservers of the subjective classification of the thyroid vascularization. METHODS: thyroid glands of 158 subjects were examined by means of duplex-Doppler sonography. After all the selection criteria, 137 individuals were selected into four groups; group N (n = 84), group A (n = 30), group I (n = 14) and II (n = 9), compounded of normal individuals, euthyroids in use of amiodarone, and patients with thyrotoxicosis types 1 and 2, respectively. All the individuals were submitted to perform the duplex-Doppler sonography of the thyroid and laboratorial tests. Also, the patients with thyrotoxicosis had also carried through 24 hour radioactive iodine uptake. RESULTS: In the group I, not only the color pixel density (CPD = 17.22 ± 20.81%) but also the values of systolic peak velocity in the superior and the inferior thyroid arteries (SPVS = 38.54 ± 18.62 cm/s and SPVI = 35.35 ± 18.08 cm/s) were greater than in the other groups (p < 0.05). The subjective agreement analysis of the vascularization patterns showed kappa weighted (kw) coefficients varying between 0.78 and 0.79 for intra-observer, and 0.83 and 0.86 for interobserver analyses. CONCLUSIONS: A) CPD is separately able to distinguish the two types of AAT. B) The best objective criteria in the distinction between AAT types 1 and 2 are the color pixel density CPD and the peak systolic velocity in the thyroid arteries. C) The subjective analyses of the vascularization pattern show good and very good intraobserver and interobserver agreements.