Analysis of the involvement of the thyroid gland using computed tomography in patients with suspected SARS-CoV-2 infection: a retrospective study.

OBJECTIVE: SARS-CoV-2 primarily infects the respiratory tract and leads to severe pneumonia by binding to the ACE-2 receptor. The virus can also interact with ACE-2 receptors expressed in other tissues as in thyroid. This study predicted the complications involving the thyroid in patients with suspected SARS-CoV-2. PATIENTS AND METHODS: Patients with suspected SARS-CoV-2 infection between March 11, 2020-May 31, 2020 were retrospectively evaluated. Sixty-nine patients who were radiologically diagnosed as COVID-19 according to thoracic CT and had previously performed thoracic CT before November 2019 were included in the study according to the exclusion and inclusion criteria. Age and gender-matched controls (No. 69) were selected with normal thoracic CT whose PCR tests were also negative. Thyroid densities of participants were calculated and compared from the previous and current thoracic CTs. Results were also compared with the control group. RESULTS: Participants were composed of 69 patients (39 male, mean age 64.35 years). Thyroid densities were significantly decreased from 89HU to 76HU for whole gland, from 88HU to 76HU for right lobes and from 87.5HU to 75.5HU for left lobes at current thoracic CTs performed during COVID-19 (p<0.001, p<0.001, p<0.001 respectively). The decrease in densities of the whole thyroid gland, both left and right lobes, was correlated with mortality (p<0.001). The changes in thyroid densities were not correlated with age nor gender. The decreases in HU values of thyroid densities for whole gland, left and right lobes, were correlated with mortality (p<0.001, p<0.001, and p<0.001 respectively). CONCLUSIONS: COVID-19 is a multi-systemic disease that threatens vital organs, including the thyroid. Future studies are needed to investigate the association between SARS-CoV-2 and other complications.

Microstructural brain changes in acromegaly: quantitative analysis by diffusion tensor imaging.

OBJECTIVE: We examined brain diffusion changes of patients with acromegaly. We searched whether there are differences in apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values between remission and non-remission patients with acromegaly and investigated any effect of time of hormone exposure on diffusion metrics. METHODS: The values of FA and ADC were calculated in a total of 35 patients with acromegaly and 28 control subjects. Patients were subdivided into remission and non-remission groups. We looked at brain FA and ADC differences among the groups and looked for any relation between the diffusion changes and time of hormone exposure among the patients with acromegaly. RESULTS: We found decreased FA and increased ADC values in some of the growth hormone responsive areas. There were no significant brain diffusion changes between remission and non-remission groups. The most affected areas were the hypothalamus, parietal white matter and pre-motor cortex in patients with acromegaly. In terms of hormone exposure time among the patients with acromegaly, there was no effect of disease duration on brain microstructural changes. CONCLUSION: All patients with acromegaly showed increased brain diffusion with no relation to disease duration and treatment status. We suggested that in patients with acromegaly, brain damage had already occurred in the subclinical period before symptom onset. ADVANCES IN KNOWLEDGE: This study contributes to the understanding of the mechanisms in acromegaly.

Intense FDG uptake on PET/CT in the upper and lower respiratory system indicative of Wegener's granulomatosis.

Wegener's granulomatosis (WG) is an uncommon systemic vasculitis, which involves the upper and lower respiratory tracts and the kidneys. Because the patients generally present with clinical manifestations that are similar to common diseases, WG may be initially misdiagnosed as infection or malignancy. We report the case of a 55-year-old male presenting with weight loss, cough, hemoptysis, low-grade fever, and pulmonary nodules detected on the thoracic CT scan. Malignancy was initially suspected, so a PET/CT was performed. It demonstrated intense FDG uptake in the upper and lower respiratory system. The diagnosis of WG was based on PET findings, elevated serum levels of inflammatory markers, and the presence of c-ANCA. We consider that the knowledge of FDG-PET/CT findings may help to make an easier and earlier diagnosis of WG.