Long-term effect of a large dose of iodinated contrast in patients with mild thyroid dysfunction: a prospective cohort study / 中华医学杂志(英文版)

BACKGROUND@#More than 75 million procedures with intravascular iodine-based contrast media (ICM) are performed worldwide every year, and some patients undergoing these procedures do not have normal thyroid function. The long-term effects of ICM in patients with mild thyroid dysfunction (TD) are unclear.@*METHODS@#This prospective cohort study was conducted in China. Patients with stable angina pectoris with total triiodothyronine (TT3) reduction, normal thyroid-stimulating hormone, and reverse triiodothyronine (rT3) were enrolled and divided into high-dose (≥100 mL ICM) and low-dose groups (<100 mL ICM). We dynamically investigated the trends in thyroid function, rT3, and thyroid antibodies one year after ICM exposure.@*RESULTS@#A total of 154 patients completed 6 months of follow-up and 149 completed 1 year of follow-up. Thyroglobulin antibody (TGAB) levels were elevated in 41 (26.6%) patients before ICM exposure, 11 (7.1%) of whom also had elevated thyroid peroxidase antibody levels. Transient subclinical TD occurred 6 months after ICM exposure; 75.5% (34/45) of post-operative TD occurred in the high-dose group. One patient developed severe hypothyroidism with myxedema, requiring drug intervention 1 year after ICM exposure. The level of rT3 showed no statistically significant changes during post-operative follow-up ( P  = 0.848). The TGAB level decreased at 6th month ( P  < 0.001), but increased at 1 year after ICM exposure ( P  = 0.002).@*CONCLUSIONS@#Patients with T3 reduction are at a risk of transient subclinical TD and hypothyroidism after a single large dose of ICM. Follow-up of this population at 9-12 months after ICM exposure is warranted.

Application of magnetic resonance imaging in the diagnosis of soft tissue sarcoma / 中国医师进修杂志

Objective To evaluate the diagnostic value of magnetic resonance imaging (MRI) in the diagnosis of soft tissue sarcoma. Methods Seventy-four soft tissue tumors patients having underwent plain and enhanced MRI scans were selected. A retrospective case-control study was conducted to compare the demographic and MRI characteristics between 32 cases of soft tissue sarcoma and 42 cases of benign soft tissue tumor. The examined MRI characteristics included lesion location, morphology, size, signal uniformity, intratumoral sign, sign outside the tumor and intensity pattern, et al. The MRI characteristics were compared between 2 groups. Results The 32 patients with soft tissue sarcoma included 7 cases with lipoblastoma, 5 cases with pleomorphic undifferentiated sarcoma, 5 cases with fibrosarcoma, 5 cases with synovial sarcoma 5 cases, 4 cases with dermatofibrosarcoma protuberant, 2 cases with low-grade fibromyxoid sarcoma, 2 cases with alveolar soft part sarcoma, 1 case with leiomyosarcoma, and 1 case with histiocytic sarcoma. The 42 patients with benign soft tissue tumor included 15 cases with neurilemmoma, 9 cases with angioma, 8 cases with neurofibroma, 6 cases with lipoma, and 4 cases with angiolipoma. After controlling for the potential confounding effects of sex and age, whether there was high signal on T2WI and whether the tumor boundary was clear can help for distinguishing soft tissue sarcoma and benign tumor. The occurrence of high signal on T2WI was a risk factor for soft tissue sarcomas ( OR=25.05, 95% CI 4.04 to 155.28), and tumors whose boundaries were less clear ( OR=18.84, 95% CI 2.98 to 118.99) and unclear ( OR=26.59, 95% CI 3.79 to 186.71) were more likely to be soft tissue sarcomas compared to those with clear boundaries. Conclusions The MRI characteristics of soft tissue sarcomas can be used for accurate diagnosis of the tumors before treatment.