Diagnostic procedure in suspected Graves’ disease

Goichot, B.; Leenhardt, Laurence; Massart, Catherine; Raverot, Véronique; Tramalloni, Jean; Iraqi, H.

doi:10.1016/j.ando.2018.08.002

Cited by 25 publications

(18 citation statements)

References 30 publications

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“…The Doppler measurement of blood flow is based on the Doppler effect, namely the change in wave frequency under reflection by a moving structure. This change depends on the blood flow velocity, the probe emission frequency and the Doppler angle, that is the angle between the ultrasound beam and the blood flow [5].…”

Section: Discussionmentioning

confidence: 99%

“…In these patients, hypoechogenicity [7], [8] and increased thyroid blood flow [6], both detected prior to discontinuing the medical treatment, predict a recurrence shortly after. These two sonographic features can be found also in untreated Graves’ disease patients [5], [8]. Increased thyroid blood flow consists of increased thyroid artery diameter (3–4 mm compared to the normal 1–2 mm), increased flow rate (>100 cm/sec), and reduced peripheral resistance [5], [10].…”

Section: Introductionmentioning

confidence: 92%

“…These two sonographic features can be found also in untreated Graves’ disease patients [5], [8]. Increased thyroid blood flow consists of increased thyroid artery diameter (3–4 mm compared to the normal 1–2 mm), increased flow rate (>100 cm/sec), and reduced peripheral resistance [5], [10]. Clinically, the hypervascularized thyroid can be accompanied by two clinical signs, namely thyroid bruit and thrill [11].…”

Section: Introductionmentioning

confidence: 96%

“…Although thyroid ultrasound examination is not obligatory for the diagnosis of Graves’ disease in case of TRAb-positive hyperthyroidism, it may help differentiate Graves’ disease from other causes of thyrotoxicosis when TRAb assay is not available or in the few TRAb-negative cases [4], [5]. Ultrasonography may also help in predicting relapse of hyperthyroidism in Graves’ disease patients off antithyroid drugs [6], [7], [8].…”

Section: Introductionmentioning

confidence: 99%

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Thyroid vascularization is an important ultrasonographic parameter in untreated Graves’ disease patients

Vita

Bari

Perelli

et al. 2019

Journal of Clinical & Translational Endocrinology

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Graves’ disease is characterized by two sonographic features, hypoechogenicity and increased blood flow. The aim of this study was to review retrospectively ultrasound features and biochemical data of a cohort of untreated Graves’ disease patients. We reviewed charts of 42 such patients, who were referred to our Endocrinology Unit from January 2013 to May 2018. One operator performed all the thyroid sonographic scans. Serum TSH, FT3, FT4 and TSH-receptor antibodies (TRAb) levels at the time of ultrasound examination were evaluated. Over a mean follow-up of 30.9 months, about one in three patients (38%) experienced at least one recurrence of hyperthyroidism (1.4 ± 0.6 recurrence per patient), either on or off antithyroid drugs. We found that thyroid vascularization correlated directly with thyroid volume and that larger thyroids tended to be more vascularized. We also found that greater vascularization was associated with marked hypoechogenicity, and greater FT4 and TRAb levels. Patients who experienced recurrence(s) had 1.7-fold higher levels of TRAb at onset. In conclusion, thyroid hypervascularization at onset of Graves’ disease is an important sonographic feature.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Thyroid vascularization is an important ultrasonographic parameter in untreated Graves’ disease patients

Vita

Bari

Perelli

et al. 2019

Journal of Clinical & Translational Endocrinology

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“…Endocrine-Related Cancer Elnaggar et al 2018). In addition, ultrasonography may be particularly useful through providing representative information of Graves' disease with diffuse, bilateral or isthmic goiter, heterogeneous and hypoechogenicity parenchyma and hypervascularization with the classical aspect so called 'thyroid inferno', and describing the characteristics of malignant thyroid nodule, including taller than wide shape, hypoechogenicity, irregular margins, calcifications, vascularity and extrathyroidal extension (Alzahrani et al 2012, Bogazzi et al 2012, Goichot et al 2018. In such situations, ultrasonography is also the primary diagnostic modality available for a guided FNA cytology/biopsy (FNAC/B) of nodules (Haugen et al 2016).…”

Section: :7mentioning

confidence: 99%

Thyrotoxicosis with concomitant thyroid cancer

Cheng

Jin

et al. 2019

Endocrine-Related Cancer

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Thyrotoxicosis with concomitant thyroid cancer is rare and poorly recognized, which may result in delayed diagnosis, inappropriate treatment and even poor prognosis. To provide a comprehensive guidance for clinicians, the etiology, pathogenesis, diagnosis and treatment of this challenging setting were systematically reviewed. According to literatures available, the etiologies of thyrotoxicosis with concomitant thyroid cancer were categorized into Graves’ disease with concurrent differentiated thyroid cancer (DTC) or medullary thyroid cancer, Marine–Lenhart Syndrome with coexisting DTC, Plummer’s disease with concomitant DTC, amiodarone-induced thyrotoxicosis with concomitant DTC, central hyperthyroidism with coexisting DTC, hyperfunctioning metastases of DTC and others. The underlying causal mechanisms linking thyrotoxicosis and thyroid cancer were elucidated. Medical history, biochemical assessments, radioiodine uptake, anatomic and metabolic imaging and ultrasonography-guided fine-needle aspiration combined with pathological examinations were found to be critical for precise diagnosis. Surgery remains a mainstay in both tumor elimination and control of thyrotoxicosis, while anti-thyroid drugs, beta-blockers, 131I, glucocorticoids, plasmapheresis, somatostatin analogs, dopamine agonists, radiation therapy, chemotherapy and tyrosine kinase inhibitors should also be appropriately utilized as needed.

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