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Wu MH, Chen CN, Chen KY, Ho MC, Tai HC, Wang YH, Chen A, Chang KJ. Quantitative analysis of echogenicity for patients with thyroid nodules. Sci Rep 2016; 6:35632. [PMID: 27762299 PMCID: PMC5071905 DOI: 10.1038/srep35632] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 10/03/2016] [Indexed: 12/16/2022] Open
Abstract
Hypoechogenicity has been described qualitatively and is potentially subject to intra- and inter-observer variability. The aim of this study was to clarify whether quantitative echoic indexes (EIs) are useful for the detection of malignant thyroid nodules. Overall, 333 participants with 411 nodules were included in the final analysis. Quantification of echogenicity was performed using commercial software (AmCAD-UT; AmCad BioMed, Taiwan). The coordinates of three defined regions, the nodule, thyroid parenchyma, and strap muscle regions, were recorded in the database separately for subsequent analysis. And the results showed that ultrasound echogenicity (US-E), as assessed by clinicians, defined hypoechogenicity as an independent factor for malignancy. The EI, adjusted EI (EIN-T; EIN-M) and automatic EI(N-R)/R values between benign and malignant nodules were all significantly different, with lower values for malignant nodules. All of the EIs showed similar percentages of sensitivity and specificity and had better accuracies than US-E. In conclusion, the proposed quantitative EI seems more promising to constitute an important advancement than the conventional qualitative US-E in allowing for a more reliable distinction between benign and malignant thyroid nodules.
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Affiliation(s)
- Ming-Hsun Wu
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Chiung-Nien Chen
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Kuen-Yuan Chen
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming-Chih Ho
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Hao-Chih Tai
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | | | - Argon Chen
- Graduate Institute of Industrial Engineering, National Taiwan University, Taipei, Taiwan
| | - King-Jen Chang
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.,Department of Surgery, Cheng Ching General Hospital, Taichung City, Taiwan
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Garcia TS, Rech TH. Thyroid volume and Doppler evaluation of inferior thyroid artery in ultrasound: Comparison between current and previous users of oral contraceptives. JOURNAL OF CLINICAL ULTRASOUND : JCU 2015; 43:312-317. [PMID: 25142871 DOI: 10.1002/jcu.22221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Revised: 07/16/2014] [Accepted: 07/21/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND This study aimed to compare thyroid volume and Doppler sonographic evaluation of the inferior thyroid artery using ultrasound in current and previous users of oral contraceptives (OCs). METHODS We evaluated 119 women who either currently use (n = 66) or have previously used OCs (n = 53) using color Doppler ultrasound for thyroid volume and resistance index, peak-systolic, and end-diastolic velocities of the inferior thyroid artery. Previous OC users were divided into two groups: previous OC use for <1 year and previous OC use for ≥1 year. RESULTS A comparison of the thyroid volume revealed an increased volume in women with previous OC use for ≥1 year and in current users compared with those with previous OC use for <1 year (previous OC use for ≥1 year: 7.49 mL versus previous OC use for <1 year: 6.13 mL; p < 0.01). The relationship between OC use and an enlarged thyroid remained after adjusting for thyroid-stimulating hormone levels (p = 0.03). There were no differences in the inferior thyroid artery blood flow measurements. CONCLUSIONS In healthy women, current use and previous OC use for ≥1 year were associated with increased thyroid volume that was unrelated to increased blood flow in the gland.
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Affiliation(s)
- Tiago Severo Garcia
- Medical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Wu MH, Chen CN, Chen KY, Ho MC, Tai HC, Chung YC, Lo CP, Chen A, Chang KJ. Quantitative analysis of dynamic power Doppler sonograms for patients with thyroid nodules. ULTRASOUND IN MEDICINE & BIOLOGY 2013; 39:1543-1551. [PMID: 23791356 DOI: 10.1016/j.ultrasmedbio.2013.03.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Revised: 02/19/2013] [Accepted: 03/07/2013] [Indexed: 06/02/2023]
Abstract
To clarify and determine whether power Doppler sonograms are useful for the detection of malignant thyroid nodules, a computerized quantification method was used to evaluate the vascular density of a thyroid nodule in a prospective setting. Sonographic power Doppler images were collected in consecutive frames (45 frames of images), and a proprietary program (AmCAD-UV) was implemented using methods proposed in this article automatically calculated a quantified power Doppler vascular index (PDVI). The minimum PDVI value (PDVImin) was suggested as a measure of the vascular density of the nodule. The vascular densities of the peripheral and central areas of the nodule, referred to as central PDVImin and Ring PDVImin, respectively, were also evaluated. For 238 tumors (79 malignant and 159 benign) from 208 patients, all of the proposed indices of benign lesions were significantly higher than those of the malignant lesions. The area under the receiver operating characteristic curve (AUC) reaches 71% with the PDVImin. When the vascular patterns were further classified into intra-nodular and peripheral vascularity types, no vascularity type was observed significantly more frequently in malignant nodules than in benign nodules. These proposed computerized vascular indices provide a quantification method to objectively evaluate thyroid nodules and have potential as predictors of thyroid malignancy. The conventional vascular characterizations of malign nodules, that is, more vessels are observed in malignant nodules than in benign nodules, are shown to be unreliable in our study. Instead, a higher value of the quantified power Doppler vascular density was observed in benign nodules.
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Affiliation(s)
- Ming-Hsun Wu
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
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Thyroid Doppler indices in patients with sickle cell disease. Clin Imaging 2013; 37:852-5. [PMID: 23834903 DOI: 10.1016/j.clinimag.2013.05.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Revised: 05/20/2013] [Accepted: 05/30/2013] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To evaluate the intrathyroidal hemodynamic changes and thyroidal volume in sickle cell disease (SCD) patients. METHODS Thirty-two patients with homozygous SCD and 32 control subjects were examined with color Doppler ultrasonography. None of the patients and control subjects had clinical or laboratory evidence of thyroid disease. RESULTS SCD patients had significantly higher resistance index (RI) and pulsatility index (PI) values and lower thyroid volume compared with control group. CONCLUSION Increased intrathyroidal RI and PI and decreased thyroid volume may be due to impaired thyroidal microcirculation. Further and follow-up studies are needed to explain the relationship between Doppler parameters and thyroid functions.
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Kot BCW, Ying MTC, Brook FM, Kinoshita RE, Cheng SCH. Ultrasonographic assessment of the thyroid gland and adjacent anatomic structures in Indo-Pacific bottlenose dolphins (Tursiops aduncus). Am J Vet Res 2013; 73:1696-706. [PMID: 23106453 DOI: 10.2460/ajvr.73.11.1696] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the use of ultrasonography for thyroid gland assessment in healthy Indo-Pacific bottlenose dolphins (Tursiops aduncus), describe the ultrasonographic appearance of the thyroid gland and adjacent anatomic structures, and identify potential associations between variations in thyroid gland morphology and demographic features in this species. ANIMALS 18 captive Indo-Pacific bottlenose dolphins. PROCEDURES 1,404 ultrasonographic examinations of the thyroid gland and adjacent anatomic structures (eg, cervical lymph nodes, musculature, and vasculature) were performed during the > 3-year study period. Shape, echogenicity, and homogeneity of thyroid glands were assessed, and glands were categorized into morphological configurations on the basis of results of 2-D and 3-D ultrasonographic evaluation. Associations between demographic factors and thyroid gland morphology were assessed. RESULTS Thyroid lobes appeared elliptical or fusiform in the transverse scan plane and round to oval in longitudinal scan planes; morphologically, glands comprised 2 lobes joined by an isthmus or a roughly diamond-shaped structure located on the ventral surface of the trachea. Major blood vessels and cervical lymph nodes were identified. Thyroid parenchyma was typically uniform and homogeneous, with echogenic reticulations and well-defined borders. Thyroid glands were hypoechoic or isoechoic relative to the sternocephalicus muscle; echogenicity was greater in adolescents than in adults. Thyroid gland volume differed between sexes, between sexually mature and immature dolphins, and among age groups and was positively correlated with body length and weight. CONCLUSIONS AND CLINICAL RELEVANCE Ultrasonography provided a reliable and repeatable method for evaluation of thyroid glands and adjacent anatomic structures in live dolphins.
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Affiliation(s)
- Brian C W Kot
- Department of Health Technology and Informatics, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China.
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Oguz A, Gumus M, Ipek A, Tuzun D, Ersoy R, Cakir B. Effects of menstrual cycle showing infradian rhythm on thyroid blood flow and thyroid volume in healthy women. BIOL RHYTHM RES 2013. [DOI: 10.1080/09291016.2011.652863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Sonographic evaluation of thyroid morphology during the normal estrous cycle in the Indo-Pacific bottlenose dolphin (Tursiops aduncus). J Zoo Wildl Med 2012; 43:256-64. [PMID: 22779228 DOI: 10.1638/2010-0196.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Physiologic changes occurring in the thyroid in response to the estrous cycle have been noted in companion animals. However, in bottlenose dolphins, the influence of different reproductive states on thyroid morphology remains unclear. Sonography was used to evaluate the variations of thyroid morphology for nine consecutive estrous cycles of four sexually mature, female Indo-Pacific bottlenose dolphins (Tursiops aduncus). The estrous cycle was divided into two phases for evaluation: the follicular and luteal phases. To compare changes associated with sex, thyroid volumes were measured in the different phases during the estrous cycle of female dolphins and were compared to the ultrasound examinations of the four male dolphins measured over a 2-mo period. In males, there was no significant difference in thyroid volume during the study period (P > 0.05). The thyroid volume measured in combining all estrous cycle phases of the female dolphins was significantly larger than that measured in the male dolphins (P < 0.05). A difference in thyroid volume during the estrous cycle was observed, with the thyroid volume during the follicular phase significantly smaller (P < 0.05) than that of the luteal phase, and is possibly related to the influence of female sex steroids. Thyroid volume variability during estrus should, therefore, be taken into account when examining the thyroid gland of female dolphins.
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Macedo TAA, Chammas MC, Jorge PT, Pereira de Souza L, Farage L, Pegoraro BL, Pessa SU, Cerri GG. Reference values for Doppler ultrasound parameters of the thyroid in a healthy iodine-non-deficient population. Br J Radiol 2007; 80:625-30. [PMID: 17681987 DOI: 10.1259/bjr/69016171] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The aim of this study was to describe normal Doppler parameter values in the thyroid arteries in an iodine-replete region. 165 individuals were randomly selected in a community located in the south-east of Brazil. We obtained a clinical history on each subject and determined serum thyrotropin, antiperoxidase antibodies, thyrotropin receptor antibody (TRAb) and thyroid volumes through ultrasound. Subjects with thyroid disease and those under 20 years of age were excluded. 84 representative subjects (30 men and 54 women) remained. The systolic peak velocity (SPV), resistive index (RI) and pulsatility index (PI) in the superior and inferior thyroid arteries were measured using a 5-12 MHz linear probe. Except for the RI, the distribution of all Doppler parameters was non-gaussian. The median and mean references for the SPV, RI and PI were 24.80 cm s(-1) and 25.85 cm s(-1), 0.60 and 0.62, and 0.98 and 1.04, respectively, for superior thyroid arteries; these reference values for the inferior thyroid artery were 20.92 cm s(-1) and 21.50 cm s(-1), 0.57 and 0.57, and 0.84 and 0.88, respectively (p<0.001). Women had greater SPV values (p<0.01). We have determined reference thyroid Doppler parameter values in our iodine-non-deficient population and prepared tables by sex and age.
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Affiliation(s)
- T A A Macedo
- Division of Ultrasound of the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo - Instituto de Radiologia, São Paulo, SP, Brazil.
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Yazici B, Simsek E, Erdogmus B, Bahcebasi T, Aktas A, Buyukkaya R, Uzun H, Safak AA. Evaluation of the thyroid blood flow with Doppler ultrasonography in healthy school-aged children. Eur J Radiol 2007; 63:286-9. [PMID: 17374471 DOI: 10.1016/j.ejrad.2007.01.036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2006] [Revised: 01/24/2007] [Accepted: 01/26/2007] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To determine the relationship between thyroid blood flow and anthropometric measurements, pubertal stage, and thyroid and gonadotropic hormones. MATERIALS AND METHODS We examined 123 healthy school-aged children prospectively (69 boys (56.1%) and 54 girls (43.9%), 7-17 years old). Their sex, age, body weight, height, body mass index (BMI), and pubertal stage were determined. Serum thyrotropin, free thyroxine, luteinizing hormone, and follicle stimulating hormone were measured in both genders, along with testosterone in boys and estradiol in girls. The peak systolic velocity (PSV), resistance index (RI), and pulsatility index (PI) of the superior thyroid artery were determined. The correlations between the Doppler parameters and these factors were investigated. RESULTS There were no differences in age, weight, height, BMI, thyroid volume, PSV, RI, or PI between boys and girls (P>0.05). The PSV and PI showed strong correlations with age, height, weight, puberty stage, thyroid volume, and BMI. The RI showed a strong inverse correlation with age, height, weight, puberty stage, and thyroid volume and a weak inverse correlation with the BMI. CONCLUSION Determination of the thyroid arterial flow in normal healthy children is important during a Doppler ultrasound (US) examination. Doppler US parameters and their percentiles should be described in healthy children from different age groups, and these percentiles will aid in interpreting Doppler US in children.
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Affiliation(s)
- Burhan Yazici
- Department of Radiology, Duzce University School of Medicine, Konuralp, Duzce 81620, Turkey.
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Krejza J, Nowacka A, Szylak A, Bilello M, Melhem LY. Variability of thyroid blood flow Doppler parameters in healthy women. ULTRASOUND IN MEDICINE & BIOLOGY 2004; 30:867-876. [PMID: 15313319 DOI: 10.1016/j.ultrasmedbio.2004.05.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2003] [Revised: 04/27/2004] [Accepted: 05/13/2004] [Indexed: 05/24/2023]
Abstract
The purpose of this study was to estimate variability of flow Doppler parameters in the superior thyroid artery (STHA) during the menstrual cycle in young women and to explore the influence of endogenous 17-b-estradiol (E2) and progesterone (PRG) on the velocity waveform. The plasma concentration of these hormones was correlated with flow velocities, pulsatility index (PUI), resistance index (RI) and acceleration index (accI) and time (accT), which were measured with color-coded duplex sonography 8 times during the cycle in 14 healthy women (age range: 23 to 25 years). Coefficient of variation (CV), interclass correlation (ICC), repeatability (repC) and pooled Pearson correlation (r) coefficients were used to estimate the variability of the parameters. The highest variability was found for accI and accT: CV = 48% and 31%; ICC = 0.51 and 0.45; repC = 2.8 and 95; r = 0.37 and 0.4, respectively. The CV for flow velocities varied from 25% to 26%, ICC from 0.53 to 0.56, repC from 8 to 17 and r has a value of 0.46. The respective values for RI and PUI were: 11%, 18%; 0.48, 0.55; 0.15, 0.48; and 0.46, 0.48. The diastolic blood pressure decreased significantly by 7 mmHg (p < 0.01) in the luteal phase, whereas other physiological variables were stable during the cycle. Although the fluctuations of the flow parameters during the cycle were not statistically significant, a weak linear correlation between flow velocities and concentration of E2 was found; for mean velocity r = 0.16, p < 0.05. Impedance indices showed an increasing trend in the luteal phase, along with increase of the pulse pressure index (PPI). The results showed that variability of the flow parameters in the STHA is substantial and that higher flow velocities are associated with increase of plasma concentration of 17-b-estradiol during the menstrual cycle in young women.
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Affiliation(s)
- Jaroslaw Krejza
- Department of Radiology, Bialystok University School of Medicine, Bialystok, Poland.
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Karadeniz MY, Yucel A, Altan Kara S, Noyan V, Altinok D, Ergin A, Bayram M, Güney S. Change in retrobulbar circulation during menstrual cycle assessed by Doppler ultrasound. ULTRASOUND IN MEDICINE & BIOLOGY 2002; 28:33-37. [PMID: 11879950 DOI: 10.1016/s0301-5629(01)00488-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Our purpose was to study the hemodynamic changes in the ophthalmic, central retinal and posterior ciliary arteries during the normal menstrual cycle and to relate the vascular changes to menstrual cycle. A total of 23 healthy women underwent serial color Doppler ultrasonography at least six times during a normal menstrual cycle, twice each in follicular, ovulatory and luteal phases. Pulsatility and resistance index and peak systolic velocity of the each arteries were assessed with color Doppler imaging. There was no statistical difference in any of the parameters during the menstrual cycle. This was supposed to be because generalized hormonal effects on heart rate, blood pressure, blood volume, cardiac output and on the diameter of the vessel cancel each other and this effect maintains the same ocular blood flow and perfusion during the menstrual cycle.
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Affiliation(s)
- Mirace Yasemin Karadeniz
- Department of Radiology, Kirikkale University, School of Medicine, Süleyman Demirel Hospital, Kirikkale, Turkey.
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Abstract
Increasing evidence derived from experimental and clinical studies suggests that the hypothalamic-pituitary-thyroid axis (HPT) and the hypothalamic-pituitary-ovarian axis (HPO) are physiologically related and act together as a unified system in a number of pathological conditions. The suggestion that specific thyroid hormone receptors at the ovarian level might regulate reproductive function, as well as the suggested influence of estrogens at the higher levels of the HPT axis, seems to integrate the reciprocal relationship of these two major endocrine axes. Both hyper- and hypothyroidism may result in menstrual disturbances. In hyperthyroidism the most common manifestation is simple oligomenorrhea. Anovulatory cycles are very common. Increased bleeding may also occur, but it is rare. Hypothyroidism in girls can cause alterations in the pubertal process; this is usually a delay, but occasionally it can result in pseudo-precocious puberty. In mature women hypothyroidism usually is associated with abnormal menstrual cycles characterized mainly by polymenorrhea, especially anovulatory cycles, and an increase in fetal wastage.
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Affiliation(s)
- A G Doufas
- Endocrine Unit, Evgenidion Hospital, University of Athens Medical School, Greece
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Chan ST, Brook F, Ahuja A, Brown B, Metreweli C. Relationship of thyroid blood flow to reproductive events in normal Chinese females. ULTRASOUND IN MEDICINE & BIOLOGY 1999; 25:233-240. [PMID: 10320312 DOI: 10.1016/s0301-5629(98)00145-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The purpose of this study was to investigate the blood flow characteristics in the superior thyroid artery (STA) in normal females of prepubertal, reproductive, and postmenopausal age. The study was performed in 29 prepubertal girls, 27 females of reproductive age, and 26 postmenopausal women. The peak systolic velocity (PSV) and the pulsatility index (PI) of the STA were measured repeatedly during one menstrual cycle in females of reproductive age, and measured once in each prepubertal and postmenopausal subject. Different waveforms were observed in females of prepubertal, reproductive, and postmenopausal age. The PSV of the STA increased progressively in females from prepubertal to postmenopausal phases. The PI of the STA in all of the prepubertal girls was lower than that of adult females in different phases of the menstrual cycle. In adult females, the PI in the follicular phase was significantly higher than those in the ovulatory and luteal phases. In all of the postmenopausal women, the PI was comparable to that in older prepubertal subjects and in adult females during the ovulatory and luteal phases. The results suggest that oestrogen may affect thyroid blood flow during the normal menstrual cycle. Growth and progressive change of arterial structure are suggested to affect the thyroid blood flow in prepubertal and postmenopausal states.
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Affiliation(s)
- S T Chan
- Department of Optometry and Radiography, Hong Kong Polytechnic University, Hunghom, Kowloon
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