One in five subjects with normal thyroid ultrasonography has altered thyroid tests

Abstract

The relation between thyroid ultrasonography and laboratory, and the relationship of thyroid volume with clinical and anthropometric parameters, are not well clarified. Aim of the study was to investigate normal and hypoechoic-inhomogeneous not nodular thyroid gland in predicting thyroid tests, and to assess the correlation of thyroid volume with several clinical parameters. The series included 434 subjects (244 with normal thyroid ultrasonography, and 190 with hypoechoic-inhomogeneous thyroid) at their first evaluation. Subjects with normal ultrasonography and skewed tests were re-evaluated after one year. All subjects with normal ultrasound showed normal free-T-4, while TSH was elevated in 9.8% of cases and thyroid antibodies were positive in another 9.8%. In patients with hypoechoic-inhomogeneous thyroid, free-T-4 was low in 33.2%, TSH was elevated in 78.4% and thyroid antibodies were positive in 76.3%. Normal ultrasonography matched with normal tests in 81.1% of cases while hypoechoic-inhomogeneous thyroid in 9.5% (p<0.001). The re-evaluation of tests showed no significant difference. In subjects with both normal ultrasonography and tests, thyroid volume was correlated with age (p=0.001), weight (p=0.003), BMI (p=0.04), body surface area (p=0.002). Thyroid laboratory assessment was different between subjects with ultrasonographically normal or hypoechoic-inhomogeneous thyroid. Thyroid volume of thyroid diseases-free subjects was correlated with age, weight, BM I and body surface area, and this should be of interest to investigate the references of normality of thyroid size

Relationship of anthropometric measurements to thyroid nodules in a Chinese population

“…In children, significant associations of BMI with thyroid nodules were also observed. Our findings in adults are consistent with results in German 34 and Italian 35 studies and similar to findings from a Korean population. 17 However, results from previous prospective and case–control studies on the association of BMI with thyroid cancer risk have generally been more inconsistent in men than women.…”

Lymphadenopathy in Autoimmune Thyroiditis: Paratracheal Lymph Nodes are Indeed Crucial

“…Blood levels of TSH, TSH-receptor antibodies (TRAB), anti-TPO-antibodies (TPOAb) and anti-Thyroglobulinantibodies (TgAb) were analyzed using chemiluminescence immunometric assays (Immulite, Siemens Medical Solutions, Los Angeles, CA; USA) using the following reference values: TSH= 0.27-4.2 µIU/ml, TPOAb= 0-35 IU/ml, TgAb= 0-40 IU/ml, TRAB= 0-1,75 IU/ml. As the sonographic pattern is decisive in the evaluation of thyroid diseases and patients with normal ultrasound show a normal serology in more than 90% of cases [7][8], no blood work was performed in the control group.…”

Analysis of tissue surrounding thyroid nodules by ultrasound digital images

“…Two expert examiners (PT, MFT) performed US using an Esaote MyLab system (Esaote, Genova, Italy) equipped with linear probe working at 8-14 MHz. The inter-observer variability for these investigators was 8.2 % [11,12]. To evaluate gland echogenicity and homogeneity, clips and freeze images for all patients were stored and blindly reviewed by the two investigators.…”

“…These papers report that hypoechogenicity of the thyroid gland represents a risk factor for developing hypothyroidism over time [7][8][9][10]. Also, at least 80 % of subjects with normal thyroid (NT) US pattern have NT function [11,12]. To recap, US examination is characterized by poor reproducibility due to high intra-and inter-observer variability [13,14].…”