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.
Subject(s)
Thyroid Gland/diagnostic imaging , Adult , Aged , Arteries/physiology , Blood Flow Velocity/physiology , Female , Humans , Male , Middle Aged , Reference Values , Systole , Thyroid Gland/blood supply , Thyroid Hormones/blood , Ultrasonography, Doppler, Color/standardsABSTRACT
PURPOSE: To evaluate the usefulness of Doppler parameters in the differentiation between the two types of amiodarone-associated thyrotoxicosis (AAT). MATERIAL AND METHODS: One hundred thirty-seven individuals were selected at our institution. They were divided into four groups: 84 normal subjects (N), 30 euthyroids taking amiodarone (A), 14 AAT type 1 patients (AAT1), and nine AAT type 2 patients (AAT2). Each AAT type was classified according to (131)I uptake and clinical outcome. Blindly, the resistance and pulsatility indexes (RI, PI), systolic peak velocity, and color pixel density (CPD) were calculated. RESULTS: AAT1 had greater CPD than AAT2 (P = 0.02). The latter group had similar vascularization to the N and A groups (P = 0.45). The area under the receiver operating characteristic (ROC) curve showed that systolic peak velocity in the inferior thyroid arteries and CPD were the best parameters in the differentiation between AAT type 1 and AAT type 2 (Az = 0.83 and 0.84, respectively). Impedance indexes were useless. CONCLUSION: Our results demonstrate that objective tests such as systolic peak velocities in the thyroid arteries and CPD are reliable parameters for differentiating between the two types of AAT.
Subject(s)
Amiodarone/adverse effects , Anti-Arrhythmia Agents/adverse effects , Thyrotoxicosis/chemically induced , Ultrasonography, Doppler, Color , Ultrasonography, Doppler, Duplex , Adult , Aged , Aged, 80 and over , Area Under Curve , Atrial Fibrillation/drug therapy , Blood Flow Velocity/physiology , Diagnosis, Differential , Female , Follow-Up Studies , Humans , Image Processing, Computer-Assisted , Male , Middle Aged , Prospective Studies , Pulsatile Flow/physiology , ROC Curve , Thyroid Gland/blood supply , Thyroid Gland/diagnostic imaging , Thyrotoxicosis/diagnostic imaging , Vascular Resistance/physiology , Ventricular Premature Complexes/drug therapyABSTRACT
Os autores apresentam um caso de alergia generalizada a insulina porcina monocomponente comprovado clinicamente e com testes intradermicos. Houve remissao do quadro apos dessesibilizacao. Comentam a raridade do fenomeno e chamam a atencao para sua importancia clinica
