The Value of Color Flow Doppler Ultrasonography of the Superior Thyroid Artery in the Surgical Management of Graves Disease

Huang, Shucheng

doi:10.1001/archsurg.138.2.146

Cited by 23 publications

(19 citation statements)

References 26 publications

(29 reference statements)

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“…In relation to this, it has been shown that the abnormal responsiveness of human forearm resistance vessels of hyperthyroid patients is corrected when euthyroidism is restored by medical treatment (6). In support of our results in thyroid arteries, an increased blood flow of the superior thyroid artery has been demonstrated in patients with Graves' disease, maintained in a euthyroid state with methimazole, prior to thyroid surgery (16). The increase in blood flow in the superior thyroid artery is positively correlated with microvessel density (17) and with vascular endothelial growth factor expression in hyperplasic follicular cells (18).…”

Section: Discussionsupporting

confidence: 84%

Nitric oxide mediates abnormal responsiveness of thyroid arteries in methimazole-treated patients

Vila¹,

Mauricio²,

Segarra³

et al. 2005

eur j endocrinol

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Objective: We studied the intervention of nitric oxide (NO), prostacyclin and endothelium-derived hyperpolarizing factor (EDHF) in mediating responses to acetylcholine in thyroid arteries from euthyroid and methimazole-treated (MT) patients. Design and methods: Branches of the superior thyroid artery were obtained from 19 euthyroid patients and 17 MT patients (euthyroid at the time of surgery) undergoing total thyroidectomy or hemithyroidectomy. Artery rings were suspended in organ baths for isometric recording of tension. Results and conclusions: Acetylcholine caused endothelium-dependent relaxation of greater magnitude in arteries from MT patients (pD 2 (2log EC 50 ) values were 7.68^0.19 in euthyroid and 8.17^0.26 in MT patients, P , 0.05). The relaxation was unaffected by indomethacin and was partially reduced by the NO-synthase inhibitor NG-monomethyl-L-arginine (L-NMMA). This reduction was higher in arteries from MT patients (50^6%) as compared with euthyroid patients (36^6%) (P , 0.05). Inhibition of K þ channels using apamin combined with charybdotoxin or high K þ solution abolished the relaxation resistance to L-NMMA and indomethacin. The maximal contraction response to noradrenaline (as a percentage of the response to 100 mM KCl) was lower in MT than in euthyroid patients (57^10 and 96^8 respectively, P , 0.05). The hyporesponsiveness to noradrenaline in arteries from MT patients was corrected by L-NMMA. The results indicate that: (i) thyroid arteries from MT patients show an increased relaxation response to acethylcholine and a decreased contraction response to noradrenaline due to overproduction of NO; (ii) EDHF plays a prominent role in acetylcholine-induced relaxation through activation of Ca 2þ -activated K þ channels; (iii) the abnormal endothelium-dependent responses in arteries from MT patients are not corrected by medical treatment.European Journal of Endocrinology 152 551-556

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Section: Discussionsupporting

confidence: 84%

Nitric oxide mediates abnormal responsiveness of thyroid arteries in methimazole-treated patients

Vila¹,

Mauricio²,

Segarra³

et al. 2005

eur j endocrinol

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“…A reduction in vascularity measured with 99m TC-pertechnetate after LS has also been shown [ 40 ]. In a number of investigations of euthyroid individuals with GD LS has reported to decrease the rate of blood flow, thyroid vascularity, and intraoperative blood loss during thyroidectomy [ 39 , 41 – 44 ].…”

Section: Vascular Effectsmentioning

confidence: 99%

Lugol’s solution and other iodide preparations: perspectives and research directions in Graves’ disease

Calissendorff

Falhammar

2017

Endocrine

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Lugol’s solution and other preparations containing iodide have for almost a century been used as an adjuvant treatment in patients with Graves’ disease planned for thyroidectomy. Iodide has been shown to decrease thyroid hormone levels and reduce blood flow within the thyroid gland. An escape phenomenon has been feared as the iodide effect has been claimed to only be temporary. Lugol’s solution has many additional effects and is used in other settings beside the thyroid. Still, there are questions of its mode of action, which doses should be deployed, if it should be used preoperative in all thyroidectomies or only in a few selected ones if at all, what is its use in other forms of thyrotoxicosis besides Graves’ disease, and what is the mechanism acting on the vasculature and if these effects are confined only to arterial vessels supporting the thyroid or not. This review aims to collate current available data about Lugol’s solution and other iodide preparations in the management of Graves’ disease and give some suggestions where more research is needed.

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“…It is worth noting that assessment of total thyroid perfusion by CDUS, which requires measurement of the flow in the four supply vessels of the thyroid gland -LSTA, LITA, RSTA, and RITA, did not facilitate discrimination between GD and health in comparison to volume flow measurement in a single supply vessel. In line with this, increased flow in the inferior or superior thyroid artery was previously reported to be indicative for GD [3, 16,20]. CDUS is an established imaging technique for evaluation of the thyroid gland owing to its low cost and wide availability.…”

mentioning

confidence: 68%

Thyroid Perfusion Imaging as a Diagnostic Tool in Graves’ Disease – Arterial Spin Labeling Magnetic Resonance Imaging vs. Colour-Coded Doppler Ultrasound

Müssig

Schraml

Rietig

et al. 2012

Fortschr Röntgenstr

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The Value of Color Flow Doppler Ultrasonography of the Superior Thyroid Artery in the Surgical Management of Graves Disease

Cited by 23 publications

References 26 publications

Nitric oxide mediates abnormal responsiveness of thyroid arteries in methimazole-treated patients

Nitric oxide mediates abnormal responsiveness of thyroid arteries in methimazole-treated patients

Lugol’s solution and other iodide preparations: perspectives and research directions in Graves’ disease

Thyroid Perfusion Imaging as a Diagnostic Tool in Graves’ Disease – Arterial Spin Labeling Magnetic Resonance Imaging vs. Colour-Coded Doppler Ultrasound

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