An evaluation of thyrotoxic autoimmune thyroiditis patients with triplex Doppler ultrasonography

Karakaş, Ömer; Karakaş, Ekrem; Çullu, Neşat; Demir, Yusuf; Kucukyavas, Yasin; Sürücü, Erdem; Yener, Serkan; Igci, Enis

doi:10.1016/j.clinimag.2013.06.010

Cited by 10 publications

(13 citation statements)

References 10 publications

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“…Thyroditis is auto limited and treated only symptomatic. On the other hand, antithyroid drugs, surgery or radioiodine therapy is necessary in GD [7] [8] [12] [13].…”

Section: Clinical and Laboratorial Diagnosismentioning

confidence: 99%

“…The thyrotoxicosis clinical manifestations in thyroiditis and mild or initial GD can be difficult to differentiate. The US Doppler provides important support in this etiologic differentiation, notedly to diffuse toxic goiter, that can be originated by destructive thyroiditis resultant from several causes or GD [6] [7] [12].…”

Section: Thyrotoxicosis Types Ultrasonography Differentiationmentioning

confidence: 99%

See 1 more Smart Citation

Graves' Disease Thyroid Color-Flow Doppler Ultrasonography Assessment: Review Article

Santos¹,

Pina²,

Souza³

et al. 2014

Health

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Graves' disease, as known today, is an autoimmune, diffuse, chronic disease of thyroid gland, as described by Robert Graves in 1835. It presents genetic predisposition and unknown etiology evidence, which is influenced in its development by several factors, including environment (dietary iodine intake, stress, drugs and infections). The disease is characterized by one or more changes: hyperthyroidism, goiter, ophthalmopathy, skin changes and pretibial myxedema, around 5% less common, and other symptoms 90% to 95%. One of the most relevant clinical practice aspects in Graves' disease patients management is to distinguish Graves' disease in initial phase, from other types of destructive thyrotoxicosis, in addition to evaluate therapeutic methods and efficient follow up, as well as predict early recurrence or remission of disease. Scintigraphy with pertechnetate (99 mTc) and TSH levels dosage are considered the choice for this purpose. However, they present some technical difficulties, as they are not widely available and have contraindications. In this scenario, thyroid color-flow doppler ultrasonography (US Doppler) presents a viable alternative, as a widely available, low cost, non-invasive and radiation free method, providing initial diagnosis and patients with Graves' disease follow up. In adittion, this method is used in differential diagnosis with other causes of thyrotoxicosis in the early stage.

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“…Thyroditis is auto limited and treated only symptomatic. On the other hand, antithyroid drugs, surgery or radioiodine therapy is necessary in GD [7] [8] [12] [13].…”

Section: Clinical and Laboratorial Diagnosismentioning

confidence: 99%

Section: Thyrotoxicosis Types Ultrasonography Differentiationmentioning

confidence: 99%

Graves' Disease Thyroid Color-Flow Doppler Ultrasonography Assessment: Review Article

Santos¹,

Pina²,

Souza³

et al. 2014

Health

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“…Another characteristic feature is enhanced blood flow of the suprathyroid artery, as seen on color Doppler [6].…”

Section: Discussionmentioning

confidence: 99%

Thyroid disease diagnosed by point-of-care ultrasound after the induction of anesthesia: a case report

Idei

Watanabe

2018

JA Clin Rep

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The importance of point-of-care ultrasound (POCUS) is increasingly recognized [1]. However, although POCUS has been used for perioperative evaluation of the heart, lungs, and airways [1][2][3], there are few reports on POCUS for perioperative evaluation of the thyroid. We report a case in which POCUS performed by an anesthesiologist in the operating room detected undiagnosed thyroid disease. Case presentationA 57-year-old woman was scheduled for spine surgery. Her preoperative examination was unremarkable, and there were no abnormal findings on blood tests, chest X-ray, and 12-lead electrocardiogram.Induction of anesthesia was performed with 200 μg of fentanyl, 80 mg of propofol, and 40 mg of rocuronium. Oxygen, air, desflurane, and remifentanil were used to maintain anesthesia. While moving the patient to a prone position, we noticed that her left neck was slightly enlarged (Fig. 1). Using an ultrasound, we found that the left lobe of her thyroid gland was enlarged heterogeneously, with hypoechoic areas and microcalcifications (Fig. 2). The margin of the left lobe was somewhat irregular, and a mass approximately 1 cm in diameter with a calcification and an acoustic shadow was detected (Fig. 3).An otolaryngologist was immediately consulted, and suspected chronic thyroiditis and papillary adenocarcinoma of the thyroid, and recommended a detailed postoperative examination. Thyroid hormone levels were not measured preoperatively.Because the patient had no symptoms suggestive of hyperthyroidism or hypothyroidism, no abnormalities on preoperative 12-lead electrocardiogram, and an uneventful course of anesthesia up to that point, we determined that the ultrasound findings would not affect her surgery and decided to continue as scheduled. Total operative time was 143 min, and total anesthesia time was 210 min. She was transferred to the ward after extubation, and the perioperative and postoperative course was unremarkable.Six days after surgery, the patient underwent otolaryngologic examination and thyroid-specific laboratory testing. The anti-thyroglobulin antibody was high at 562 IU/mL (normal values 0-28 IU/mL) and the antithyroid peroxidase antibody was also high, at 40 IU/ mL (normal values 0-16 IU/mL). Her thyroid hormones (free triiodothyronine, free thyroxine, and thyroid-stimulating hormone) were within the normal range. Aspiration biopsy cytology revealed chronic thyroiditis (Hashimoto's disease) and papillary thyroid adenocarcinoma. The left lobe of the thyroid was resected for thyroid carcinoma 7 months after the first surgery, and the patient is currently being followed up in the otolaryngology department.

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“…Again, in a study that compares RAIU levels and PSV values of STA in DDUS for GD and DT patients, significant results were reported for PSV (average optimum cut off value was 42.25 cm/sec) 19 . It was mentioned that the blood flow parameters obtained in DDUS examination of the superior thyroidal artery can be used in the clinical diagnosis of patients with hyperthyroidism 20,21 . It was mentioned that PSV values of STA might be complementary to RAIU in order to distinguish the causes of hyperthyroidism 22 .…”

Section: Introductionmentioning

confidence: 99%

Do Superior Thyroidal Artery Doppler Findings Play a Role in the Differential Diagnosis of Hyperthyroidism?

Eldeş¹,

Turan²,

Çeliker³

et al. 2020

Ahi Evran Medical Journal

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Hipertiroidinin erken tanı ve doğru tedavisi, ilişkili sistemik komplikasyonları önleyebilmek açısından önemlidir. Ayırıcı tanıda serum tiroid hormonları, tiroid otoantikorları ve radyoaktif iyot uptake sintigrafisi kullanılmakta ancak bu incelemelerle kesin tanıya gidilememektedir. Çalışmamızda laboratuar bulgularının yanında süperior tiroidal arterin dublex doppler ultrason bulgularının tanıya katkısını değerlendirdik. Bu doppler bulgularının, gri scala ultrasonografi bulgularına ek destekleyici bir yöntem olabileceğini göstermeyi amaçladık. Araçlar ve Yöntem: Çalışmaya 75'i kadın ve 21'i erkek olmak üzere toplam 96 kişi dahil edildi. Hipertiroidili gruplar graves hastalığı (GD) ve toksik multınoduler guatrı olan (TMNG); sırasıyla 29 ve 41 kişiydi. Kontrol grubu olarak çalışmaya ötiroid 26 kişi dahil edildi. Tüm bireylere yapılan dublex doppler ultrason ile süperior tiroidal arterlerinin pik sistolik hız, end diastolik hız ve rezistivite index değerlerine bakıldı. Pik sistolik değerlerinin toksik multinodüler guatr grubunda graves hastalarına göre anlamlı yüksek olduğu bulundu. Bulgular: TMNG and GD hastalarında, pik sistolik hız, diyastol sonu hız ve rezistif index değerleri kontrol grubuna göre anlamlı yüksek bulundu (p<0.001). TMNG ve GD hastaları karşılaştırıldığında ise sadece pik sistolik hız değeri TMNG'li grup lehine anlamlı yüksek b ulundu. TMNG'li grubun (50.5±26.5 cm/sec) ve GD'li (34.2±11.5 cm/sec) grubun pik sistoli hız değerleri klinik tanı anında karşılaştırıldı. Sonuç: Hipertiroidi ayırıcı tanısında sintigrafinin gerekli olduğu yerlerde süperior tiroidal arterin pik sistolik hız de ğerlerinin kullanılabileceği kanaatindeyiz. Böylece alınabilecek potansiyel radyasyon dozu ve kaybedilecek zaman önlenebilir.

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An evaluation of thyrotoxic autoimmune thyroiditis patients with triplex Doppler ultrasonography

Cited by 10 publications

References 10 publications

Graves' Disease Thyroid Color-Flow Doppler Ultrasonography Assessment: Review Article

Graves' Disease Thyroid Color-Flow Doppler Ultrasonography Assessment: Review Article

Thyroid disease diagnosed by point-of-care ultrasound after the induction of anesthesia: a case report

Do Superior Thyroidal Artery Doppler Findings Play a Role in the Differential Diagnosis of Hyperthyroidism?

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