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1.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 42(1): 80-85, 2020 Feb 28.
Artigo em Chinês | MEDLINE | ID: mdl-32131944

RESUMO

Objective To investigate the value of contrast-enhanced ultrasound(CEUS)quantitative parameters in the diagnosis of thyroid benign and malignant nodules. Methods The CEUS features of 85 histopathologically confirmed thyroid nodules were quantitatively analyzed using five parameters including rising time(RT),time to peak(TTP),area under the curve(AUC),maximum intensity(Imax),and mean transit time(mTT).The dynamic vascular pattern(DVP)curves were also drawn. Results The Imax(Z=-7.08,P=0.01)and AUC(Z=-2.03,P=0.04)of thyroid malignant nodules were significantly smaller than those of thyroid tissue,and the Imax(Z=-1.35,P=0.02)and AUC(Z=-0.21,P=0.02)of thyroid benign nodules were significantly larger than those of thyroid tissue.There were significant differences between thyroid benign and malignant nodules in Imax(Z=-4.16,P=0.00),AUC(Z=-3.01,P=0.01),and DVP curve types(P=0.00).RT(Z=-0.28,P=0.62),TTP(Z=-0.10,P=0.89),and mTT(Z=-0.79,P=0.05)were not significantly different between thyroid benign and malignant nodules. Conclusion The quantitative parameters of CEUS,especially Imax and AUC parameters,are valuable in the diagnosis of benign and malignant thyroid nodules.


Assuntos
Neoplasias da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/diagnóstico por imagem , Ultrassonografia , Meios de Contraste , Diagnóstico Diferencial , Humanos , Glândula Tireoide/diagnóstico por imagem
4.
Ann R Coll Surg Engl ; 102(3): e63-e66, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31841033

RESUMO

Calcitonin-negative medullary thyroid carcinoma is a rare, poorly understood primary neuroendocrine carcinoma of the thyroid characterised by classic medullary thyroid carcinoma morphology without raised serum calcitonin. A 24-year-old woman presented with a slow-growing, right-sided neck swelling. She underwent an ultrasound scan, cytopathological and histopathological examination, and tests for alternative diagnoses. The ultrasound showed a heterogeneous, hyperechoic nodule in the right thyroid lobe. Serum calcitonin was normal. Cytopathology and histopathology showed typical medullary thyroid carcinoma morphology but without calcitonin upon immunostaining and mRNA in situ hybridisation. A 'triple-negative' calcitonin-negative medullary thyroid carcinoma was diagnosed. A completion thyroidectomy with bilateral central lymph node dissection was performed. The patient remains well three-years post-surgery. When cytopathology suggests a medullary thyroid carcinoma, serum calcitonin, pro-calcitonin, carcinoembryonic antigen and calcitonin-gene-related peptide should be measured to identify cases of calcitonin-negative medullary thyroid carcinoma. They should also be measured post-treatment for monitoring purposes. This will aid future calcitonin-negative medullary thyroid carcinoma diagnoses and will inform prognostic stratification and influence treatment decisions.


Assuntos
Calcitonina/sangue , Carcinoma Neuroendócrino/sangue , Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/sangue , Biomarcadores Tumorais/sangue , Biópsia , Carcinoma Neuroendócrino/diagnóstico , Carcinoma Neuroendócrino/cirurgia , Feminino , Humanos , Fenótipo , Glândula Tireoide/cirurgia , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia/métodos , Tomografia Computadorizada por Raios X , Ultrassonografia , Adulto Jovem
5.
J Clin Ultrasound ; 48(1): 3-6, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31418860

RESUMO

Numerous sets of guidelines have been proposed regarding ultrasound of thyroid nodules. None has been universally accepted. American College of Radiology-Thyroid Imaging, Reporting and Data System (ACR-TIRADS) has been promoted as an improvement to existing guidelines such as the 2015 revised American Thyroid Association (ATA) guidelines. This commentary compares and contrasts these two guidelines. Adoption of TI-RADS is likely to result in large-scale, costly surveillance without clear benefit. Replacement of 2015 revised ATA guidelines by TI-RADS is not justified. The shortcomings that exist in the ATA guidelines can be addressed as described in this commentary.


Assuntos
Guias de Prática Clínica como Assunto , Nódulo da Glândula Tireoide/diagnóstico por imagem , Biópsia , Diagnóstico Diferencial , Detecção Precoce de Câncer/normas , Humanos , Sociedades Médicas , Glândula Tireoide/diagnóstico por imagem , Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/patologia , Ultrassonografia , Estados Unidos
6.
Surgery ; 167(1): 40-45, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31515121

RESUMO

BACKGROUND: Postoperative follow-up of papillary thyroid cancer includes serial serum thyroglobulin levels. This study aimed to determine whether stimulated thyroglobulin levels measured in the early postoperative period can accurately quantify the risk of recurrence in papillary thyroid cancer. METHODS: We undertook a cohort study of patients who underwent total thyroidectomy for papillary thyroid cancer ≥10 mm in the period 2000 to 2016 with complete biochemical data. All patients had a postoperative stimulated thyroglobulin measured within 3 months after total thyroidectomy. Structural recurrence was defined as disease detected on imaging and confirmed on histology. Biochemical disease was defined as patients with stimulated serum thyroglobulin ≥1 ng/mL with no evidence of structural disease. RESULTS: This study included 502 patients with a mean age of 50 years and median tumor diameter of 20 mm. Median follow-up was 18 months. Stimulated postoperative thyroglobulin was measured before radioiodine-ablation and was categorized into 3 groups: (1) 219 (44%) patients had thyroglobulin <1 ng/mL; (2) 55 (11%) had 1ng/mL ≤ thyroglobulin <2 ng/mL; and (3) 228 (45%) had thyroglobulin ≥2 ng/mL. The structural recurrence rate for each group was 5%, 2%, and 30%, respectively (P < .0001). CONCLUSION: In patients undergoing total thyroidectomy for papillary thyroid cancer, early postoperative stimulated thyroglobulin accurately quantifies the risk of structural disease recurrence.


Assuntos
Recidiva Local de Neoplasia/epidemiologia , Tireoglobulina/sangue , Câncer Papilífero da Tireoide/terapia , Neoplasias da Glândula Tireoide/terapia , Tireoidectomia , Adulto , Idoso , Idoso de 80 Anos ou mais , Intervalo Livre de Doença , Feminino , Seguimentos , Humanos , Radioisótopos do Iodo/administração & dosagem , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/diagnóstico , Tomografia por Emissão de Pósitrons , Período Pós-Operatório , Estudos Retrospectivos , Medição de Risco/métodos , Câncer Papilífero da Tireoide/diagnóstico , Câncer Papilífero da Tireoide/mortalidade , Glândula Tireoide/diagnóstico por imagem , Glândula Tireoide/cirurgia , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/mortalidade , Fatores de Tempo , Tomografia Computadorizada por Raios X , Ultrassonografia , Adulto Jovem
7.
Surgery ; 167(1): 28-33, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31515126

RESUMO

BACKGROUND: The evaluation of the malignancy risk of thyroid nodules involves clinical factors, sonographic characteristics, cytopathology, and molecular profiling. Altogether, this algorithm can be costly and time consuming. We evaluated the stepwise contribution of each diagnostic step toward an accurate prediction of malignancy. METHODS: A retrospective study of dominant nodules of 137 patients who underwent surgical excision was performed. A baseline logistic regression model for predicting malignancy was regressed on clinical factors. In a stepwise fashion, the 2015 American Thyroid Association ultrasound risk stratification, Bethesda classification of fine-needle aspiration biopsies, and molecular profiling were added to the baseline model and the significance of each step analyzed using likelihood ratio test. Receiver operating characteristic curves were calculated for each model. RESULTS: The addition of American Thyroid Association risk stratification and Bethesda classification to preceding models were statistically significant (P < .001). The addition of molecular profiling (as a strategy independent of a particular test) was not significant (P = .812). The areas under the curve of the baseline model and models sequentially including American Thyroid Association stratification, cytopathology, and molecular profiling were 0.76, 0.85, 0.91, and 0.91, respectively. CONCLUSION: Clinical factors, sonographic characteristics, and cytopathology are sufficiently accurate in predicting malignancy risk of most thyroid nodules.


Assuntos
Câncer Papilífero da Tireoide/diagnóstico , Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/diagnóstico , Nódulo da Glândula Tireoide/diagnóstico , Adulto , Idoso , Algoritmos , Biomarcadores Tumorais/genética , Biópsia por Agulha Fina , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Curva ROC , Estudos Retrospectivos , Medição de Risco/métodos , Câncer Papilífero da Tireoide/genética , Câncer Papilífero da Tireoide/cirurgia , Glândula Tireoide/diagnóstico por imagem , Glândula Tireoide/cirurgia , Neoplasias da Glândula Tireoide/genética , Neoplasias da Glândula Tireoide/cirurgia , Nódulo da Glândula Tireoide/genética , Nódulo da Glândula Tireoide/cirurgia , Tireoidectomia , Ultrassonografia
8.
Surgery ; 167(1): 173-179, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31526579

RESUMO

BACKGROUND: The aim of this study was to determine both the accuracy of near infrared fluorescence imaging to detect parathyroid glands and the potential indications of near infrared fluorescence imaging in thyroid and parathyroid surgery by correlating the autofluorescence signature with the pathologic specimen. METHODS: This was an institutional review board-approved, prospective study of patients undergoing thyroidectomy and parathyroidectomy with near infrared fluorescence imaging. Each specimen sent to pathology was inspected with near infrared fluorescence imaging and predicted to be either parathyroid or non-parathyroid tissue by its autofluorescence signature and then correlated with the pathologic findings. RESULTS: Autofluorescence was demonstrated to be present in 98% of the parathyroid glands, with 23% identified correctly with infrared based on the autofluorescence signature before visual identification by the surgeon. There were 550 specimens that were imaged with autofluorescence and then sent to pathology. For these samples, sensitivity, specificity, and positive and negative predictive values to predict parathyroid tissue were 98.5%, 97.2%, 95.1%, and 99.1%. In 5% of the total thyroidectomy specimens, incidentally resected parathyroid glands were identified with autofluorescence, leading to their subsequent reimplantation. In patients with parathyroid disease and negative preoperative localization, 21% of abnormal glands were recognized with autofluorescence before visual identification by the surgeon. CONCLUSION: Although the ability of infrared autofluorescence to confirm the presence of parathyroid tissue within surgical specimens was high, its power to find parathyroid glands in situ before visual recognition by surgeons was low. These advantages and limitations should be kept in mind when incorporating this technology into an endocrine surgical practice. Once a parathyroid seems to have been identified by the surgeon or tissue that looks like a parathyroid gland is identified, the autofluorescence signature is a very accurate assurance of parathyroid tissue.


Assuntos
Hipoparatireoidismo/prevenção & controle , Cuidados Intraoperatórios/métodos , Imagem Óptica , Glândulas Paratireoides/diagnóstico por imagem , Complicações Pós-Operatórias/prevenção & controle , Tireoidectomia/efeitos adversos , Adulto , Idoso , Feminino , Humanos , Hipoparatireoidismo/etiologia , Masculino , Pessoa de Meia-Idade , Glândulas Paratireoides/patologia , Glândulas Paratireoides/cirurgia , Paratireoidectomia/métodos , Complicações Pós-Operatórias/etiologia , Valor Preditivo dos Testes , Estudos Prospectivos , Sensibilidade e Especificidade , Glândula Tireoide/diagnóstico por imagem , Glândula Tireoide/patologia , Glândula Tireoide/cirurgia , Tireoidectomia/métodos
9.
Surgery ; 167(1): 110-116, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31543327

RESUMO

BACKGROUND: Papillary thyroid microcarcinoma is a subtype of thyroid cancer that may be managed with active surveillance rather than immediate surgery. Active surveillance decreases complication rates and may decrease health care costs. This study aims to analyze complication rates of thyroid surgery, papillary thyroid microcarcinoma recurrence, and survival rates. Additionally, the costs of surgery versus hypothetic active surveillance for papillary thyroid microcarcinoma are compared in an Australian cohort. METHODS: Papillary thyroid microcarcinoma patients were included from a prospectively collected surgical cohort of patients treated for papillary thyroid cancer between 1985 and 2017. The primary outcomes were the complications of thyroid surgery, recurrence-free survival, overall survival, and cost of surgical treatment and active surveillance. RESULTS: In a total of 349 patients with papillary microcarcinoma with a median age of 48 years (range, 18-90 years), the permanent operative complications rate was 3.7%. Postoperative radioactive iodine did not decrease recurrence-free survival (P = .3). The total cost of surgical treatment was $10,226 Australian dollars, whereas hypothetic active surveillance was at a yearly cost of $756 Australian dollars. Estimated cost of surgical papillary thyroid microcarcinoma treatment was equivalent to the cost of 16.2 years of active surveillance. CONCLUSION: Surgery may have a long-term economic advantage for younger Australian patients with papillary thyroid microcarcinoma who are likely to require more than 16.2 years of follow-up in an active surveillance scheme.


Assuntos
Carcinoma Papilar/terapia , Análise Custo-Benefício , Custos de Cuidados de Saúde/estatística & dados numéricos , Neoplasias da Glândula Tireoide/terapia , Tireoidectomia/economia , Conduta Expectante/economia , Adolescente , Adulto , Assistência ao Convalescente/economia , Idoso , Idoso de 80 Anos ou mais , Austrália/epidemiologia , Carcinoma Papilar/economia , Carcinoma Papilar/mortalidade , Progressão da Doença , Intervalo Livre de Doença , Feminino , Humanos , Imagem por Ressonância Magnética/economia , Masculino , Pessoa de Meia-Idade , Tomografia por Emissão de Pósitrons/economia , Estudos Prospectivos , Estudos Retrospectivos , Medição de Risco , Taxa de Sobrevida , Glândula Tireoide/diagnóstico por imagem , Glândula Tireoide/patologia , Glândula Tireoide/cirurgia , Neoplasias da Glândula Tireoide/economia , Neoplasias da Glândula Tireoide/mortalidade , Tomografia Computadorizada por Raios X/economia , Adulto Jovem
10.
Medicine (Baltimore) ; 98(52): e18564, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31876758

RESUMO

BACKGROUND: This study was designed to systematically evaluate the clinical efficacy and safety of ultrasound-guided intrathyroidal injection of glucocorticoids (GCs) versus routine oral administration of GCs for subacute thyroiditis (SAT) and to help seek evidence of evidence-based medicine (EBM) for ultrasound-guided intrathyroidal injection of GCs in the treatment of SAT. METHODS: Seven Chinese and English databases, including Chinese National Knowledge Infrastructure, Wanfang Data, VIP Information China Science and Technology Journal Database, SinoMed, PubMed, Cochrane Library, and Embase, were searched to collect randomized control trials on ultrasound-guided intrathyroidal injection of GCs in the treatment of SAT, which were published up to July 1, 2019. According to the method as described in Cochrane Reviewers' Handbook 5.1.0, the Cochrane Collaboration's tool for assessing risk of bias was employed to evaluate the quality of the literatures included. Statistical analysis was made by using Stata 12.0. The "metanif" command was used for sensitivity analysis to assess the stability of the results. Funnel diagram method, Egger linear regression method, and clipping complement method were used to evaluate publication bias. RESULTS: This study was carried out in strict accordance with the standard procedures for meta-analysis in the Cochrane Reviewers' Handbook 5.1.0. Critical data about the primary and secondary outcome measures were obtained by statistical analysis. CONCLUSION: This study would draw a definite conclusion about whether ultrasound-guided intrathyroidal injection of GCs is effective and safe in the treatment of SAT on the basis of EBM. This conclusion would provide scientific evidence for the clinical treatment of SAT.


Assuntos
Glucocorticoides/administração & dosagem , Tireoidite Subaguda/tratamento farmacológico , Ultrassonografia de Intervenção , Administração Oral , Glucocorticoides/uso terapêutico , Humanos , Injeções/efeitos adversos , Injeções/métodos , Glândula Tireoide/diagnóstico por imagem , Resultado do Tratamento , Ultrassonografia de Intervenção/efeitos adversos , Ultrassonografia de Intervenção/métodos
11.
BMC Musculoskelet Disord ; 20(1): 629, 2019 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-31881874

RESUMO

BACKGROUND: Nowadays, Anterior Cervical Discectomy and Fusion (ACDF) is considered a routine procedure. However, unexpected difficulties do occasionally arise, especially when anterior neck pathologies or anatomical variations are encountered. In such cases, proactive thinking will allow surgeons to tailor appropriately their approach and eliminate surgical risks. CASE PRESENTATION: We present the case of a 50-year-old male patient suffering from left upper limb radiculopathy that underwent a C7-T1 ACDF combined with a hemithyroidectomy. Excision of the right thyroid lobe was offered to the patient because of a goiter found during the preoperative work-up. Furthermore, the hemithyroidectomy provided a wide surgical field so the ACDF performed without excreting excessive traction to the adjacent neck structures. CONCLUSIONS: The patient had an uncomplicated post-operative. To our knowledge this is the first report of a planned hemithyroidectomy being carried out as the first step towards an ACDF procedure.


Assuntos
Discotomia/métodos , Cervicalgia/cirurgia , Radiculopatia/cirurgia , Fusão Vertebral/métodos , Nódulo da Glândula Tireoide/cirurgia , Tireoidectomia/métodos , Vértebras Cervicais/cirurgia , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Cervicalgia/etiologia , Radiculopatia/complicações , Glândula Tireoide/diagnóstico por imagem , Glândula Tireoide/patologia , Glândula Tireoide/cirurgia , Nódulo da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/patologia , Resultado do Tratamento , Extremidade Superior/inervação
12.
Medicine (Baltimore) ; 98(50): e18320, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31852120

RESUMO

OBJECTIVE: We aimed to investigate the value of the combined use of high-resolution ultrasound thyroid imaging reporting and data system (TI-RADS) classification and thyroid fine needle aspiration cytology (Bethesda classification) for the qualitative diagnosis of benign and malignant thyroid nodules. METHODS: We enrolled 295 patients with 327 thyroid nodules who were scheduled to undergo thyroid nodule surgery. Before surgery, all the patients underwent ultrasound and scoring with the TI-RADS classification, along with thyroid fine needle biopsy cytology under ultrasound guidance (US-FNAC) and scoring with the Bethesda classification. After surgery, the TI-RADS and Bethesda classification scores, separately and in combination, were compared with the postoperative pathological results in terms of the differential diagnosis of thyroid nodules. RESULTS: TI-RADS classification score 4 exhibited the highest diagnostic value for thyroid cancer; the sensitivity, specificity, and accuracy were 92.7%, 70.7%, and 87.1%, respectively, whereas the Kappa and receiver-operating characteristics (ROC) values were 0.651 and 0.817, respectively. Moreover, Bethesda classification score 3 exhibited the highest diagnostic value for thyroid cancer; the sensitivity, specificity, and accuracy were 90.0%, 94.3%, and 91.1%, respectively, whereas the Kappa and ROC values were 0.78 and 0.914, respectively. With regard to the combined diagnostic method, a score of 7 exhibited the highest diagnostic value for thyroid cancer; the sensitivity, specificity, and accuracy were 97.3%, 92.0%, and 95.9%, respectively, whereas the Kappa and ROC values were 0.893 and 0.946, respectively. CONCLUSION: The combination of high-resolution ultrasonography TI-RADS classification and US-FNAC (Bethesda classification) can improve the accuracy of malignant thyroid nodules diagnosis.


Assuntos
Biópsia por Agulha Fina/métodos , Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/classificação , Tomografia Computadorizada por Raios X/métodos , Ultrassonografia/métodos , Adolescente , Adulto , Idoso , Criança , Diagnóstico Diferencial , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Curva ROC , Estudos Retrospectivos , Nódulo da Glândula Tireoide/diagnóstico , Adulto Jovem
13.
Medicine (Baltimore) ; 98(44): e17657, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689776

RESUMO

New sonographic patterns have been recommended by the 2015 American Thyroid Association (ATA) to stratify nodules in terms of malignancy risk and help guide biopsy decision. This study aimed to compare the ultrasound part of the ATA guidelines and the Thyroid Imaging Reporting and Data System (TIRADS-Na).In 2013 to 2016, 708 thyroid nodules in 505 patients were confirmed by postoperative histopathology. Hypoechogenicity, solidity, microcalcification, irregular margin, and a taller-than-wide shape were considered features suggesting malignancy. Sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) were obtained for the TIRADS and ATA guidelines.Of the 708 nodules, 341(48.2%) and 367(51.8%) were benign and malignant, respectively. Based on the ultrasound 2015 ATA guidelines, 62 nodules had nonspecific pattern (both malignant and benign features); malignancy rates of nodules with very low, low, intermediate, and high suspicion, and nonspecific pattern were 0, 17.7%, 57.9%, 90.0%, and 69.4%, respectively (P < .001). Malignancy rates of categories 2/3/4/5 nodules by TIRADS were 0, 8.1%, 67.0%, and 90.1%, respectively (P < .001). Based on pathological results, the AUC, sensitivity, specificity, NPV, and PPV were 0.926, 96.7%, 81.5%, 84.9%, and 95.9% for TIRADS, and 0.920, 93.5%, 82.4%, 85.1%, and 92.1% for ATA patterns, respectively. The TIRADS was generally more efficient than the 2015 ATA guidelines, especially for nodules >2 cm in diameter or those with nonspecific pattern.The TIRADS show a relative superiority over the ultrasound 2015 ATA guidelines, especially for nodules with >2 cm diameter or nonspecific pattern.


Assuntos
Índice de Gravidade de Doença , Glândula Tireoide/diagnóstico por imagem , Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Sistemas de Dados , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Medição de Risco , Sensibilidade e Especificidade , Neoplasias da Glândula Tireoide/diagnóstico , Ultrassonografia , Estados Unidos , Adulto Jovem
14.
Pesqui. vet. bras ; 39(11): 923-931, Nov. 2019. tab, graf, ilus
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1056913

RESUMO

Few reports have been published regarding the use of ultrasonography as a method of evaluating the normal thyroid gland in horses. For these reasons, this study aimed at determining reliably of the thyroid measurements from the comparison between the left and right thyroid lobes, as well as assessing the contour, format, echotexture and echogenicity of the healthy thyroid by mode-B ultrasonography. Additionally, the equine thyroid vascularization was quali-quantitatively characterized the by Doppler. The sample size initially was determined by the animal selection with advanced age and without volume increase in the neck proximal region. Finally, eleven horses were selected by laboratory test, search of thyroid neoformations by ultrasonography and cytology thyroid. Next, these animals were submitted to thyroid lobes ultrasonographic evaluation. Excellent reproducibility was observed for all measurements obtained. Among the comparisons made between the quantitative parameters of the left and right lobes, it was observed that there was only difference between their respective lengths. Qualitatively, there was a significant variation between the lobes elliptical format in the longitudinal plane of some glands, which oscillated between a rounded and flattened conformation. Thus, we can conclude that the difference between the lobes format of some thyroids can be explained by the significant difference observed between the length of the left and right lobes. Additionally, it was verified that there was no difference between the Doppler quantitative parameters. Therefore, we may suggest that unilateral analysis of the cranial thyroid artery by spectral Doppler can be used to evaluate equine thyroid diffuse disorders.(AU)


Poucas análises foram publicadas com relação ao uso da ultrassonografia como método de avaliação da glândula tireoide hígida em equinos. Alguns trabalhos incluem a determinação das dimensões e características do parênquima. Por essas razões, este estudo teve como objetivo determinar com segurança as medidas tireoidianas a partir da comparação entre o lobo tireoidiano esquerdo e direito, bem como avaliar os contornos, formato, ecotextura e ecogenicidade das glândulas tireoides hígidas pela ultrassonografia em modo B. Além disso, a vascularização da tireoide equina foi caracterizada quali-quantitativamente pela ferramenta Doppler. O tamanho da amostra inicialmente foi determinado pela seleção dos animais com idade avançada e sem aumento de volume na região proximal do pescoço. Por fim, onze equinos foram selecionados por meio de exame laboratorial, pesquisa de neoformações tireoidianas por ultrassonografia e citologia da tireoide. Em seguida, estes animais foram submetidos à avaliação de lobos tireoidianos por ultrassonografia. Observou-se excelente reprodutibilidade em relação a todas as medidas deste estudo. Foram observadas diferenças qualitativas entre os lobos tireoidianos direito e esquerdo. Assim, podemos concluir que tais diferenças entre o formato dos lobos tireoidianos podem ser explicadas pela diferença significativa e/ou tendência observada no parâmetro comprimento entre os respectivos lobos. Além disso, não foi encontrada diferença significativa entre os valores da artéria tireoidiana cranial esquerda em relação aos obtidos na artéria tireoidiana cranial direita, sugerindo que a análise dos valores espectrais do Doppler de uma das artérias tireoidianas craniais possa ser utilizada como método de avaliação de distúrbios difusos da tireoide equina.(AU)


Assuntos
Animais , Glândula Tireoide/anatomia & histologia , Glândula Tireoide/diagnóstico por imagem , Cavalos , Ultrassonografia/veterinária , Parâmetros
15.
Medicine (Baltimore) ; 98(39): e17286, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574847

RESUMO

BACKGROUND: This study aims to systematically investigate the impact of ultrasound angiography (UA) combined with fine needle aspiration (FNA) for the diagnosis of thyroid nodules (TNs). METHODS: The following electronic databases will be searched: MEDLINE, EMBASE, Cochrane Library, PsycINFO, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure. We will search them from their inceptions to the present without language limitations. We will consider all case-controlled studies on investigating the impact of diagnosis UA combined FNA for TNs. We will apply Quality Assessment of Diagnostic Accuracy Studies tool to assess methodological quality for all eligible studies. RESULTS: In this study, outcomes consist of sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio. All these outcomes will be analyzed to evaluate the diagnostic accuracy of UA combined with FNA for TNs. CONCLUSION: This study will provide evidence of the diagnostic accuracy of UA combined with FNA for TNs. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019138884.


Assuntos
Angiografia/estatística & dados numéricos , Biópsia por Agulha Fina/estatística & dados numéricos , Biópsia Guiada por Imagem/estatística & dados numéricos , Nódulo da Glândula Tireoide/diagnóstico , Ultrassonografia/estatística & dados numéricos , Angiografia/métodos , Biópsia por Agulha Fina/métodos , Estudos de Casos e Controles , Humanos , Biópsia Guiada por Imagem/métodos , Razão de Chances , Projetos de Pesquisa , Sensibilidade e Especificidade , Revisões Sistemáticas como Assunto , Glândula Tireoide/diagnóstico por imagem , Ultrassonografia/métodos
16.
Medicine (Baltimore) ; 98(38): e17192, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31567964

RESUMO

BACKGROUND: Previous clinical studies have reported that ultrasound-guided fine needle aspiration cytology (UGFNAC) can be used for the diagnosis of thyroid nodules (TN) effectively. However, no study has systematically explored its diagnosis accuracy in patients with TN. Thus, this study will assess its diagnosis accuracy for TN. METHODS: We will perform a comprehensive literature search from the following databases from their inceptions to the present without language restrictions: MEDILINE, EMBASE, Cochrane Library, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure. We will consider all case-controlled studies investigating the impacts of UGFNAC diagnosis for patients with TN for inclusion. Two authors will independently carry out study selection, data collection, and methodological quality assessment. Quality Assessment of Diagnostic Accuracy Studies tool will be used for methodological quality evaluation. We will use RevMan V.5.3 and Stata V.12.0 software to perform statistical analysis. RESULTS: We will apply sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio to judge the diagnostic accuracy of UGFNAC for TN. CONCLUSION: The results of this study will provide latest evidence for the diagnostic accuracy of UGFNAC for TN. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019138805.


Assuntos
Biópsia por Agulha Fina , Nódulo da Glândula Tireoide/diagnóstico , Ultrassonografia de Intervenção , Biópsia por Agulha Fina/métodos , Humanos , Glândula Tireoide/diagnóstico por imagem , Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/patologia , Ultrassonografia de Intervenção/métodos
17.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 50(3): 433-437, 2019 May.
Artigo em Chinês | MEDLINE | ID: mdl-31631614

RESUMO

Objective: To identify risk factors associated with thyroid nodular lesions in patients with acromegaly. Methods: Clinical and thyroid ultrasonography data of patients with acromegaly diagnosed in the West China Hospital of Sichuan University from May 2009 to January 2018 were reviewed and analyzed. Multivariate linear regression models were established to identify factors associated with thyroid volumes and size of thyroid nodules. Multivariate binary logistic regression models were established to determine risk factors associated with thyroid nodules in patients with acromegaly. Results: Of the 240 acromegaly patients, 70 received thyroid ultrasonography and 56 had thyroid nodules (56/70, 80%). The patients with thyroid nodules had a longer median duration of acromegaly than 14 patients who without thyroid nodules (8.0 years vs. 3.0 years, P<0.05), but had a similar mean age and female to male ratio with the latter. The risk of thyroid nodules increased with the duration of acromegaly (odds ratio=1.306, 95% confidence interval (1.010, 1.688), P=0.042). The level of random growth hormone was linearly correlated with thyroid volumes. Gender, age, and serum growth hormone were not predictors of thyroid nodules in patients with acromegaly. Conclusion: Duration of acromegaly is an independent predictor of thyroid nodules.


Assuntos
Acromegalia/complicações , Nódulo da Glândula Tireoide/complicações , China , Feminino , Humanos , Masculino , Fatores de Risco , Glândula Tireoide/diagnóstico por imagem , Glândula Tireoide/patologia
18.
Arch Endocrinol Metab ; 63(5): 495-500, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31482952

RESUMO

OBJECTIVES: The differentiation between the various etiologies of thyrotoxicosis, including those with hyperthyroidism (especially Graves' disease [GD], the most common cause of hyperthyroidism) and without hyperthyroidism (like thyroiditis), is an important step in planning specific therapy. Technetium-99m (99mTc) pertechnetate thyroid scanning is the gold standard in differentiating GD from thyroiditis. However, this technique has limited availability, is contraindicated in pregnancy and lactation, and is not helpful in cases with history of recent exposure to excess iodine. The aim of this study was to identify the diagnostic value of the peak systolic velocity of the inferior thyroid artery (PSV-ITA) assessed by color-flow Doppler ultrasound (CFDU) and compare the sensitivity and specificity of this method versus 99mTc pertechnetate thyroid uptake. SUBJECTS AND METHODS: We prospectively analyzed 65 patients (46 with GD and 19 with thyroiditis). All patients were evaluated with clinical history and physical examination and underwent 99mTc pertechnetate scanning and measurement of TRAb levels and PSV-ITA values by CFDU. The diagnosis was based on findings from signs and symptoms, physical examination, and 99mTc pertechnetate uptake. RESULTS: Patients with GD had significantly higher mean PSV-ITA values than those with thyroiditis. At a mean PSV-ITA cutoff value of 30 cm/sec, PSV-ITA discriminated GD from thyroiditis with a sensitivity of 91% and specificity of 89%. CONCLUSION: Measurement of PSV-ITA by CFDU is a good diagnostic approach to discriminate between GD and thyroiditis, with sensitivity and specificity values comparable to those of 99mTc pertechnetate thyroid uptake.


Assuntos
Doença de Graves/diagnóstico por imagem , Glândula Tireoide/diagnóstico por imagem , Tireoidite/diagnóstico por imagem , Adulto , Velocidade do Fluxo Sanguíneo , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Sensibilidade e Especificidade , Pertecnetato Tc 99m de Sódio , Glândula Tireoide/irrigação sanguínea
19.
Med Ultrason ; 21(3): 251-256, 2019 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-31476204

RESUMO

AIM: To study the ultrasonographic (US) differences between "mummified" thyroid nodules and malignant thyroid nodules in order to achieve a more accurate imaging-based diagnosis and to avoid unnecessary biopsy. MATERIAL AND METHODS: We retrospectively reviewed the US features of mummified thyroid nodules, as confirmed by fine-needle aspiration cytology (FNAC), in 193 cases. The US features included content, echo, shape, margin, microcalcification, suspicious lymph nodes and some characteristic features, including the cystic wall shrinkage sign, the concentric configuration or finger sign, calcification and halo. All of these features were classified and compared with those of 109 malignant lesions. The changes of these mummified nodules during the follow-up period were also examined. RESULTS: The cystic wall shrinkage sign and the concentric configuration or finger sign were highly specific indicators of mummified thyroid nodules and could be used to distinguish mummified nodules from thyroid cancer with a specificity of 91.7% and 99.9%, respectively. A continuous decrease in the cyst size was observed during follow-up. CONCLUSIONS: Mummified thyroid nodules are characterized by the cystic wall shrinkage sign and the concentric configuration or finger sign on US and a continuous decrease in size during follow-up. These features may be useful for the differential imaging-based diagnosis of mummified versus malignant thyroid nodules.


Assuntos
Nódulo da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/patologia , Ultrassonografia/métodos , Biópsia por Agulha Fina , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade , Glândula Tireoide/diagnóstico por imagem , Glândula Tireoide/patologia
20.
Medicine (Baltimore) ; 98(37): e17165, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31517868

RESUMO

A thyroid cancer ultrasonography screening for all residents 18 years old or younger living in the Fukushima prefecture started in October 2011 to investigate the possible effect of the radiological contamination after the Fukushima Daiichi Nuclear Power Plant accidents as of March 12 to 15, 2011. Thyroid cancer in 184 cases was reported by February 2017. The question arises to which extent those cancer cases are a biological consequence of the radiation exposure or an artefactual result of the intense screening of a large population.Experiences with the Chernobyl accident suggest that the external dose may be considered a valid surrogate for the internal dose of the thyroid gland. We, therefore, calculated the average external effective dose-rate (µSv/h) for the 59 municipalities of the Fukushima prefecture based on published data of air and soil radiation. We further determined the municipality-specific absolute numbers of thyroid cancers found by each of the two screening rounds in the corresponding municipality-specific exposed person-time observed. A possible association between the radiation exposure and the thyroid cancer detection rate was analyzed with Poisson regression assuming Poisson distributed thyroid cancer cases in the exposed person-time observed per municipality.The target populations consisted of 367,674 and 381,286 children and adolescents for the 1st and the 2nd screening rounds, respectively. In the 1st screening, 300,476 persons participated and 270,489 in the 2nd round. From October 2011 to March 2016, a total of 184 cancer cases were found in 1,079,786 person-years counted from the onset of the exposure to the corresponding examination periods in the municipalities. A significant association between the external effective dose-rate and the thyroid cancer detection rate exists: detection rate ratio (DRR) per µSv/h 1.065 (1.013, 1.119). Restricting the analysis to the 53 municipalities that received less than 2 µSv/h, and which represent 176 of the total 184 cancer cases, the association appears to be considerably stronger: DRR per µSv/h 1.555 (1.096, 2.206).The average radiation dose-rates in the 59 municipalities of the Fukushima prefecture in June 2011 and the corresponding thyroid cancer detection rates in the period October 2011 to March 2016 show statistically significant relationships.


Assuntos
Acidente Nuclear de Fukushima , Neoplasias Induzidas por Radiação/epidemiologia , Doses de Radiação , Neoplasias da Glândula Tireoide/epidemiologia , Adolescente , Criança , Pré-Escolar , Relação Dose-Resposta à Radiação , Detecção Precoce de Câncer , Geografia Médica , Humanos , Incidência , Lactente , Recém-Nascido , Japão/epidemiologia , Modelos Estatísticos , Neoplasias Induzidas por Radiação/diagnóstico por imagem , Prevalência , Exposição à Radiação/efeitos adversos , Glândula Tireoide/diagnóstico por imagem , Glândula Tireoide/efeitos da radiação , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Ultrassonografia
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