Thyroid ultrasound findings in a follow-up survey of children from three Japanese prefectures: Aomori, Yamanashi and Nagasaki

Abstract Purpose Thyroid ultrasound is a key tool in the evaluation of the thyroid, but billions of people around the world lack access to ultrasound imaging. In this study, we tested an asynchronous telediagnostic ultrasound system operated by individuals without prior ultrasound training which may be used to effectively evaluate the thyroid and improve access to imaging worldwide. Methods The telediagnostic system in this study utilizes volume sweep imaging (VSI), an imaging technique in which the operator scans the target region with simple sweeps of the ultrasound probe based on external body landmarks. Sweeps are recorded and saved as video clips for later interpretation by an expert. Two operators without prior ultrasound experience underwent 8 h of training on the thyroid VSI protocol and the operation of the telemedicine platform. After training, the operators scanned patients at a health center in Lima. Telediagnostic examinations were sent to the United States for remote interpretation. Standard of care thyroid ultrasound was performed by an experienced radiologist at the time of VSI examination to serve as a reference standard. Results Novice operators scanned 121 subjects with the thyroid VSI protocol. Of these exams, 88% were rated of excellent image quality showing complete or near complete thyroid visualization. There was 98.3% agreement on thyroid nodule presence between VSI teleultrasound and standard of care ultrasound (Cohen’s kappa 0.91, P < 0.0001). VSI measured the thyroid size, on average, within 5 mm compared to standard of care. Readers of VSI were also able to effectively characterize thyroid nodules, and there was no significant difference in measurement of thyroid nodule size (P = 0.74) between VSI and standard of care. Conclusion Thyroid VSI telediagnostic ultrasound demonstrated both excellent visualization of the thyroid gland and agreement with standard of care thyroid ultrasound for nodules and thyroid size evaluation. This system could be deployed for evaluation of palpable thyroid abnormalities, nodule follow-up, and epidemiological studies to promote global health and improve the availability of diagnostic imaging in underserved communities.

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Ultrasound Screening for Thyroid Carcinoma in Childhood Cancer Survivors: A Case Series

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2008-1528 ◽

2008 ◽

Vol 93 (12) ◽

pp. 4840-4843 ◽

Cited By ~ 51

Author(s):

Enrico Brignardello ◽

Andrea Corrias ◽

Giuseppe Isolato ◽

Nicola Palestini ◽

Luca Cordero di Montezemolo ◽

...

Keyword(s):

Thyroid Carcinoma ◽

Cancer Survivors ◽

Childhood Cancer ◽

Outcome Measure ◽

Childhood Cancer Survivors ◽

Ultrasound Screening ◽

Thyroid Ultrasound ◽

Main Outcome Measure ◽

Head Neck

Context: Childhood cancer survivors need regular monitoring into young adulthood and beyond, because they are at risk for developing late-onset complications of cancer therapy, including second malignancies. Objective: This study focuses on the use of thyroid ultrasound to screen for thyroid carcinoma in a population of childhood cancer survivors. Patients: A total of 129 subjects who had received radiotherapy to the head, neck, or upper thorax for a pediatric cancer were studied in the setting of a long-term follow-up unit. Design: Thyroid ultrasound usually began 5 yr after radiotherapy and was repeated every third year, if negative. Median follow-up time since childhood cancer diagnosis was 15.8 yr (range 6.1–34.8 yr). Solid thyroid nodules were found in 35 patients. Fine-needle aspiration was performed in 19 patients, of which 14 had nodules above 1 cm. Main Outcome Measure: The main outcome measure was the finding of not palpable thyroid cancers. Results: Cytological examination of specimens diagnosed papillary carcinoma in five patients who underwent surgery. The cytological diagnosis of papillary thyroid carcinoma was confirmed in all cases by histological examination. Notably, only two of these patients had palpable nodules; the other three were smaller than 1 cm and were detected only by ultrasound. However, histological examination showed nodal metastases in two of these. Conclusions: Although ultrasound screening for thyroid cancer in the general population is not cost effective and could lead to unnecessary surgery, due to false positives, we believe that in childhood cancer survivors who received radiotherapy involving the head, neck, or upper thorax, it would be worthwhile.

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Association between ultrasonography echogenicity and heterogeneity and thyroid function in autoimmune diffuse thyroid diseases in children and adolescents

10.21203/rs.3.rs-557677/v1 ◽

2021 ◽

Author(s):

Ji Eun Park ◽

Sook Min Hwang ◽

Ji-Young Hwang ◽

Jin Hee Moon ◽

Ik Yang ◽

...

Keyword(s):

Thyroid Function ◽

Thyroid Dysfunction ◽

Thyroid Stimulating Hormone ◽

Thyroid Diseases ◽

Overt Hypothyroidism ◽

Thyroid Ultrasound ◽

Thyroid Status ◽

Children And Adolescent ◽

Overt Hyperthyroidism

Abstract Purpose: To evaluate the association between thyroid echogenicity and heterogeneity seen on ultrasonography (US) and thyroid function in pediatric and adolescent populations with autoimmune diffuse thyroid diseases (AITD).Methods: From 2000 to 2020, we reviewed thyroid ultrasound (US) images and thyroid function statuses in 133 children and adolescent AITD patients. Our review of the images focused on decreased echogenicity and heterogeneity, which were classified into four grades.Results: Among patients with overt hypothyroidism or overt hyperthyroidism, 94.2% (65/69) showed a US grade of 3 or 4. In patients with subclinical hyper/hypothyroidism or euthyroidism, 45.3% (29/64) showed grades 1 or 2. There were no overt hyper/hypothyroidism patients with US grade 1. When we compared US grades according to thyroid status, more severe thyroid dysfunction was significantly associated with higher US grade (p=0.047). Thyroid stimulating hormone (TSH) level differed significantly according to US grades when we evaluated hyperthyroid (p=0.035) and hypothyroid (p=0.027) states independently. 11 patients showed both US grade and thyroid function status changes on follow-up US.Conclusions: In children and adolescent AITD patients, there was an association between decreased echogenicity and heterogeneity on US and thyroid dysfunction.

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Thyrotoxicosis: a rare presentation of molar pregnancy

BMJ Case Reports ◽

10.1136/bcr-2021-242131 ◽

2021 ◽

Vol 14 (7) ◽

pp. e242131

Author(s):

Eison De Guzman ◽

Hira Shakeel ◽

Rohit Jain

Keyword(s):

Vaginal Bleeding ◽

Unplanned Pregnancy ◽

Laboratory Data ◽

Mental Health Disorder ◽

Thyroid Storm ◽

Molar Pregnancy ◽

Rare Presentation ◽

Dilation And Curettage ◽

Ultrasound Findings

A 49-year-old woman, G8P7, presented with 1 week of worsening vaginal bleeding and abdominal cramps in the setting of a recently discovered unplanned pregnancy. Vaginal ultrasound findings and a significantly elevated human chorionic gonadotropin (hCG) level were concerning for molar pregnancy. She developed signs of hyperthyroidism on the night of admission, for which the endocrinology team was consulted. Laboratory data were consistent with hyperthyroidism. The patient was believed to have thyrotoxicosis secondary to molar pregnancy with concern for impending thyroid storm. Her mental health disorder and bacteraemia made taking care of her further challenging. She was started on a beta-blocker, antithyroid agent and intravenous corticosteroids. She underwent an uncomplicated suction dilation and curettage (D&C), with resolution of her symptoms a few days after. At a follow-up appointment, the patient continued to be asymptomatic and was feeling well.

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Analyses of pathological cranial ultrasound findings in neonates that fall outside recent indication guidelines: results of a population-based birth cohort: survey of neonates in Pommerania (SNiP-study)

BMC Pediatrics ◽

10.1186/s12887-019-1843-6 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Judith Weise ◽

Matthias Heckmann ◽

Hagen Bahlmann ◽

Till Ittermann ◽

Heike Allenberg ◽

...

Keyword(s):

Neonatal Intensive Care ◽

Periventricular Leukomalacia ◽

Population Based ◽

Cranial Ultrasound ◽

Group I ◽

Ultrasound Findings ◽

Group Ii ◽

Current Guidelines ◽

Population Based Survey

Abstract Background Recent guidelines recommend a cranial ultrasound (CU) in neonates born at < 30 weeks gestation, admitted to the neonatal intensive care unit (NICU), or with a CU indication. Here, we addressed the need to extend these recommendations. Methods We retrospectively reviewed 5107 CUs acquired in the population-based Survey of Neonates in Pomerania, conducted in 2002 to 2008. Neonates with conspicuous CUs that were ≥ 30 weeks gestation without recent indications for CU were identified and assigned to the following groups: with (I) or without (II) admission to neonatal care. We designated CU conspicuities as mild (MC) or significant (SC), and we investigated related neurodevelopment during follow-up. Results Of 5107 neonates, 5064 were born at ≥30 weeks gestation and of those, 4306 received CUs without any indication for this examination. We found conspicuities in 7.7% (n = 47/610) of group I (n = 30 MC, n = 17 SC), and 3.2% (n = 117/3696) of group II (n = 100 MC, n = 17 SC). In group II, SC comprised, e.g., bilateral cysts, partial agenesis of the corpus callosum, and periventricular leukomalacia. Follow-up was available in 75% of infants in group II with MCs and SCs; of these, 12.8% had an abnormal neurological follow-up. Conclusions We detected a high number of conspicuities in neonates without a CU indication. However, we could not demonstrate that ultrasound findings were associated with the neurological follow-up or any advantage to an earlier diagnosis. Our data did not support extending current guidelines or a general CU screening policy for all neonates.

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Analysis of Carotid Ultrasound Findings on Cardiovascular Events in Patients with Coronary Artery Disease during Seven-Year Follow-Up

Korean Circulation Journal ◽

10.4070/kcj.2015.45.1.28 ◽

2015 ◽

Vol 45 (1) ◽

pp. 28 ◽

Cited By ~ 8

Author(s):

Hyung Bin Yuk ◽

Hyun Woong Park ◽

Ik Ju Jung ◽

Wan Ho Kim ◽

Ki-Hong Kim ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Cardiovascular Events ◽

Carotid Ultrasound ◽

Ultrasound Findings ◽

Artery Disease

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FP640A THREE YEAR FOLLOW-UP MULTICENTER STUDY REGARDING CARDIAC ULTRASOUND FINDINGS AND THEIR PROGNOSTIC VALUE IN HD PATIENS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfz106.fp640 ◽

2019 ◽

Vol 34 (Supplement_1) ◽

Author(s):

Lazar Chisavu ◽

Adalbert Schiller ◽

Flaviu Bob ◽

Florica Gadalean ◽

adelina mihaescu ◽

...

Keyword(s):

Multicenter Study ◽

Prognostic Value ◽

Cardiac Ultrasound ◽

Ultrasound Findings

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P303 Role of parietal healing by ultrasound in the evolution of patients with Crohn’s disease

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjz203.432 ◽

2020 ◽

Vol 14 (Supplement_1) ◽

pp. S304-S305

Author(s):

P Mayor Delgado ◽

C J Suarez Ferrer ◽

J Poza Cordon ◽

E Martin Arranz ◽

J L Rueda Garcia ◽

...

Keyword(s):

Crohn’S Disease ◽

Survival Analysis ◽

Crohn's Disease ◽

Median Survival ◽

Statistical Significance ◽

Inflammatory Activity ◽

First Year ◽

Ultrasound Findings

Abstract Background The objective of this study is to assess the degree of parietal involvement with ultrasound and see how they influence the prognosis according to the findings. Methods It was defined as ‘parietal healing’ the normalisation of ultrasound findings in a previously affected segment (parietal thickness less than 3 mm and absence of parietal hyperaemia). Therefore, patients with absence of ultrasound activity but without reaching parietal healing were considered to be those without significant inflammatory signs (parietal thickness <4.5 mm and absence of hyperaemia or other inflammatory data) but who had not ‘normalised’ the previously affected segment. Results A total of 111 patients without ultrasound inflammatory activity were included. It was studied whether normalisation of parameters in a previously affected segment, i.e. parietal healing gave a better prognosis during follow-up. It was detected that 74 patients achieved ‘parietal healing’ and this subgroup of patients generally had a flare in 12% of cases (9/74 patients) compared with 27% of cases (10/37) among patients without parietal healing, these differences were statistically significant (p = 0.05). Similar, it was identified that among patients without ultrasound activity who had a subsequent outbreak during follow-up, the median survival was lower (1,09 years) in patients without parietal healing vs. those with parietal healing (1.4 years), the differences reaching statistical significance (p = 0.03). Likewise, during the follow-up, it was objectived, by means of survival analysis, that the evolution of patients without ultrasound activity was more favourable in those with ‘parietal healing’ with remission 95% vs. 90% at first year, 89% vs. 81% at 2 years and 85% vs. 66% at 3 years of follow-up. The results are outlined in Figure 1. Conclusion To conclude, detecting parietal healing by ultrasound improves prognosis by decreasing the number of outbreaks and increasing the median survival until outbreaks occur.

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Follow-up of Toxoplasmosis during Pregnancy: Ten-Year Experience in a University Hospital in Southern Brazil

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1055/s-0039-1697034 ◽

2019 ◽

Vol 41 (09) ◽

pp. 539-547 ◽

Cited By ~ 2

Author(s):

Amanda Andrade Diesel ◽

Suzana de Azevedo Zachia ◽

Ana Lúcia Letti Müller ◽

Amanda Vilaverde Perez ◽

Flavio Antonio de Freitas Uberti ◽

...

Keyword(s):

Amniotic Fluid ◽

Pregnant Women ◽

Triple Therapy ◽

Gestational Age ◽

Congenital Toxoplasmosis ◽

Immunoglobulin M ◽

University Hospital ◽

Pcr Analysis ◽

Ultrasound Findings

Abstract Objective To describe a population of pregnant women diagnosed with toxoplasmosis and their respective newborns, describing the hospital protocol for treatment and follow-up. Methods Retrospective cohort of pregnant women with acute toxoplasmosis infection and risk of transplacental transmission who were sent to the Fetal Medicine Group of Hospital de Clínicas de Porto Alegre (HCPA) between - January 1, 2006 and December 31, 2016. All patients with confirmed disease were included. The diagnostic protocol and treatment were applied; a polymerase chain reaction (PCR) analysis of the amniotic fluid was used to diagnose toxoplasmosis and determine the treatment. The newborns were followed up at the pediatric outpatient clinic specializing in congenital infection. The patients who were not followed up or were not born in the HCPA were excluded. Results A total of 65 patients were confirmed to have gestational toxoplasmosis; 40 performed amniocentesis, and 6 (15%) were identified as having positive PCR in the amniotic fluid. In five of those cases, this result associated with the gestational age defined the triple therapy during pregnancy, and in one case, it defined the monotherapy (advanced gestational age). A total of 4 of these newborns were treated from birth with triple therapy for 10 months, 1 was not treated (due to maternal refusal), and 1 progressed to death within the first 54 hours of life due to complications of congenital toxoplasmosis. Of the 34 remaining cases with a negative PCR, 33 were treated with monotherapy and 1 was treated with triple therapy (ultrasound findings); of these children, 9 (26.5%) presented negative immunoglobulin G (IgG), 24 (70.6%) presented positive IgG (but none presented positive immunoglobulin M [IgM]), and 1 (2,9%) presented alterations compatible with congenital disease and started treatment with the triple therapy soon after birth. Out of the total sample of 60 patients, among the 25 who did not perform amniotic fluid PCR, 5 were treated with triple therapy (ultrasound findings/prior treatment) and 20 patients were submitted to monotherapy; only two newborns underwent treatment for congenital toxoplasmosis. Among the 65 cases of gestational toxoplasmosis, 6 (9,2%) children had a diagnosis of congenital toxoplasmosis, and 2 patients with triple therapy felt severe adverse effects of the medications. Conclusions The present study suggests that research on PCR screening of the amniotic fluid may be useful to identify patients with a higher potential for fetal complications, who may benefit from the poly-antimicrobial treatment. Patients with negative PCR results must continue to prevent fetal infection with monotherapy, without risk of fetal or maternal impairment.

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