AIM: Our aim was to examine the contribution of shear wave elastography to ultrasonographic assessment in diffuse thyroid disease, specifically to evaluate the stiffness of the thyroid gland in diffuse thyroid disease and compare it with healthy controls. METHODS: A total of 46 patients with diffuse thyroid disease were examined clinically, by conventional ultrasound, and shear wave elastography. The conventional ultrasound parameters followed were: volume, margin quality, presence of nodules, and vascularisation. We measured the mean, minimum, and maximum stiffnesses by shear wave elastography. Results were correlated with values in 128 healthy subjects. RESULTS: Patients with diffuse thyroid disease had significantly higher mean and maximal stiffnesses of the thyroid gland: 12.5 ± 5 kPa and 35.3 ± 12.8 kPa, respectively, and lower minimal stiffness: 0.5 ± 0.6 kPa than the healthy control group with mean, maximal, and minimal values of 9.5 ± 3.6 kPa, 22.5 ± 7.3 kPa, and 2.2 ± 2.1 kPa (P<0.001). Stiffness values were positively correlated with BMI and volume of the thyroid; they did not correlate with margin quality, presence of nodules nor vascularisation. Compared with healthy volunteers, thyroid glands of patients with diffuse thyroid disease had a blurred margin more frequently and the amount of nodules and vascularisation were higher. Patients with Graves-Basedow disease did not have significantly different mean, maximal, nor minimal stiffnesses than those with thyroiditis. CONCLUSION: Both mean and maximal stiffness of the thyroid gland are significantly higher in diffuse thyroid disease than in the healthy population, while minimal stiffness is lower.

• Klíčová slova
• diffuse thyroid disease, elastography, shear wave, ultrasound,
• MeSH
• elastografie * MeSH
• lidé MeSH
• nemoci štítné žlázy * diagnostické zobrazování   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

INTRODUCTION: Ultrasound-guided percutaneous ethanol injection therapy (US-PEIT) is a minimally invasive procedure that may be performed as an alternative to surgery for the treatment of recurrent symptomatic thyroid cysts for which simple aspiration failed. The present study aimed at assessing US-PEIT in a large cohort of patients, identifying factors influencing treatment outcome. METHODS: Retrospective analysis of 193 patients with 200 thyroid cysts who underwent US-PEIT in 2004-2018. RESULTS: The initial median cyst volume was 8.5 mL [5.5-16.0]; median final volume at 12 months after the completion of therapy was 0.5 mL [0.2-1.3]. A Volume Reduction Rate (VRR) of 95.0% [86.7-98.0] was achieved. For successful US-PEIT, relatively small total amount of ethanol was needed, on average corresponding to 20.0% [16.7-28.6] of the initial cyst volume. VRR positively correlated with the initial cyst volume and negatively with the presence of complex cyst. Multiple regression analysis showed the presence of complex cyst as an independent predictor of treatment efficacy. CONCLUSION: US-PEIT of thyroid cysts of all sizes was very successful with using total amounts of ethanol, corresponding to ≈20% of the initial cyst volume.

• Klíčová slova
• thyroid cyst, ultrasound-guided percutaneous ethanol injection therapy, volume reduction rate,
• MeSH
• cysty diagnostické zobrazování   farmakoterapie   MeSH
• dospělí MeSH
• ethanol terapeutické užití   MeSH
• injekce do léze MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• nemoci štítné žlázy diagnostické zobrazování   farmakoterapie   MeSH
• retrospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ultrasonografie MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• ethanol MeSH

BACKGROUND: Fine-needle biopsy of the thyroid gland is the most common interventional procedure used to diagnose thyroid diseases. Serious complications are rare in this procedure. They comprise an infection with abscess formation and hemorrhage. To date, only a few case reports have described an ultrasound diagnosis of active bleeding into the thyroid gland. We established such a diagnosis using computed tomography (CT). PATIENT FINDINGS: A 74-year-old woman presented to the emergency department of our hospital with complications after fine-needle biopsy of the thyroid gland. Ultrasound revealed a large hematoma surrounding the gland. A subsequent CT scan confirmed the presence of hematoma and, moreover, showed active bleeding. This finding prompted rapid surgical intervention. CONCLUSION: CT has the capability to show active bleeding into the thyroid gland.

• MeSH
• biopsie tenkou jehlou pod endosonografickou kontrolou škodlivé účinky   MeSH
• bolest krku etiologie   MeSH
• hematom diagnostické zobrazování   etiologie   chirurgie   MeSH
• lidé MeSH
• nemoci štítné žlázy diagnostické zobrazování   etiologie   chirurgie   MeSH
• počítačová rentgenová tomografie MeSH
• pooperační krvácení diagnostické zobrazování   etiologie   chirurgie   MeSH
• senioři MeSH
• štítná žláza diagnostické zobrazování   zranění   patologie   chirurgie   MeSH
• urgentní služby nemocnice MeSH
• uzlová struma diagnóza   patologie   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

Thyroid abscess is a relatively rare yet dramatic condition of the thyroid gland requiring immediate therapeutic intervention. Traditionally, more or less aggressive surgical approaches and administration of broad-spectrum antibiotics have been used. Clinically less severe disease allows non-surgical treatment as well. The case report describes successful treatment of a large abscess of iatrogenic origin after biopsy of a cystic cavity. A combination of broad-spectrum antibiotics was used based on culture results, administered both orally and by repeated application directly into the abscess cavity using an ultrasound-guided fine-needle approach. Concurrent repeated evacuation of the cavity replaced drainage. Ultimately, a small residual cavity with sterile contents was managed by sclerotization with absolute alcohol. Clinical condition permitting, thyroid abscess may be successfully treated by repeated application of a targeted antibiotic, using a fine needle and ultrasound guidance, directly into the abscess cavity, with repeated evacuation replacing drainage.

• MeSH
• absces diagnostické zobrazování   farmakoterapie   etiologie   mikrobiologie   terapie   MeSH
• antibakteriální látky aplikace a dávkování   terapeutické užití   MeSH
• ciprofloxacin aplikace a dávkování   terapeutické užití   MeSH
• cysty patologie   MeSH
• dospělí MeSH
• Enterobacter * izolace a purifikace   MeSH
• enterobakteriální infekce diagnostické zobrazování   farmakoterapie   etiologie   mikrobiologie   terapie   MeSH
• ethanol aplikace a dávkování   terapeutické užití   MeSH
• gentamiciny aplikace a dávkování   terapeutické užití   MeSH
• infekce v ráně diagnostické zobrazování   farmakoterapie   etiologie   mikrobiologie   terapie   MeSH
• intervenční ultrasonografie * MeSH
• kombinovaná terapie MeSH
• lidé MeSH
• nemoci štítné žlázy diagnostické zobrazování   farmakoterapie   etiologie   mikrobiologie   terapie   MeSH
• skleroterapie * MeSH
• sklerotizující roztoky aplikace a dávkování   terapeutické užití   MeSH
• tenkojehlová biopsie škodlivé účinky   MeSH
• tracheotomie MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• přehledy MeSH
• Názvy látek
• antibakteriální látky MeSH
• ciprofloxacin MeSH
• ethanol MeSH
• gentamiciny MeSH
• sklerotizující roztoky MeSH

BACKGROUND: It is controversial whether screening program for thyroid disorders in pregnancy should be universal or targeted case-finding. To evaluate the relationship between history, laboratory parameters and thyroid ultrasound (TUS) in pregnant women positive in universal screening. SUBJECTS AND METHODS: The screening included investigation of serum TSH (thyroid stimulating hormone) and TPOAb (antithyroperoxidase antibodies) in 5,520 unselected pregnant women in the 9-11th gestational week. In 822 the screening was positive: abnormal TSH (> 3.67 or < 0.06 mIU/l) and/or positive TPOAb (> 143 kIU/l). 200 consecutive women with positive screening were included it the study. RESULTS: 41 women (21%) had transient gestational hyperthyroidism (TGH) and 159 (79%) had a thyroid pathology: 10 (5%) overt hypothyroidism; 76 (38%) subclinical hypothyroidism, 7 (3.5%) overt hyperthyroidism and 66 (33%) euthyroid TPOAb positivity. After exclusion of TGH, only 74/159 (47%) women were classified as high-risk for thyroid disease according to their history. There were no significant clinical and laboratory differences between the high- vs. low-risk women, except for higher proportion of FT4<75th percentile (P=0.008) and larger thyroid volume in the high-risk group (P=0.04). Finally, only 66/126 (52%) of TPOAb-positive pregnant women had autoimmune pattern in TUS in comparison with 41/49 (84%) TPOAb-positive non-pregnant control women of comparable age (P<0.001). CONCLUSIONS: Less than half of the positively screened pregnant women can be classified as high-risk and almost half of them had not autoimmune pattern in TUS. High- and low-risk pregnant women have similar clinical and laboratory characteristics.

• MeSH
• autoantigeny MeSH
• autoprotilátky analýza   MeSH
• dospělí MeSH
• jodidperoxidasa antagonisté a inhibitory   MeSH
• komplikace těhotenství diagnostické zobrazování   epidemiologie   imunologie   patologie   MeSH
• lidé MeSH
• nemoci štítné žlázy diagnostické zobrazování   epidemiologie   imunologie   patologie   MeSH
• nemocnice univerzitní MeSH
• plošný screening MeSH
• prevalence MeSH
• prospektivní studie MeSH
• proteiny vázající železo antagonisté a inhibitory   MeSH
• první trimestr těhotenství MeSH
• rizikové faktory MeSH
• štítná žláza diagnostické zobrazování   imunologie   patologie   MeSH
• stupeň závažnosti nemoci MeSH
• těhotenství MeSH
• thyreotropin krev   MeSH
• ultrasonografie MeSH
• velikost orgánu MeSH
• zdraví ve městech MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH
• Názvy látek
• autoantigeny MeSH
• autoprotilátky MeSH
• jodidperoxidasa MeSH
• proteiny vázající železo MeSH
• thyreotropin MeSH
• TPO protein, human MeSH Prohlížeč

The study provides an overview of current possibilities for use of nuclear medicine methods in endocrine diagnostics and therapy. Somatostatin receptor analogue is applied to the hypothalamus-hypophysis system, analogue medium to is used, in thyroid diagnostics, besides the determined tumour markers, tenchecium-labelled MIBI radioiodine 131 is used to determine and monitor carcinomas. Recently, rhTSH before starting thyroid carcinoma treatment is used. Neuroendocrinology tumours are suspected through 123I-MIBG; when scintigraphy is positive, therapeutic 131I-MIBG can be administrated. In diagnostics of the pituitary gland, two-step scintigraphy of MIBI is preferably used rather than subtraction methods. In patients with late or not significantly differenciated malignant tumours, positrone emission tomography is of benefit.

• MeSH
• lidé MeSH
• nemoci štítné žlázy diagnostické zobrazování   MeSH
• radiofarmaka MeSH
• radioisotopová scintigrafie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• radiofarmaka MeSH

INTRODUCTION: Thyroid gland with mildly decreased or significantly decreased echogenity is indicating possible autoimmune disorder even before first symptoms, i.e. change in laboratory tests measuring the level of thyroid hormones and antibodies to thyroid antigens occur. TARGET: to consider changes in thyroid gland echogenity suspecting thyroid autoimmune disorder and to determine antibodies to thyroid antigens in the respective type of thyroid echogenity (increased, normal, mildly decreased or significantly decreased) to consider the activity of autoimmune thyropathies related to echogenity and to compare these factors. METHODS: Echogenity of the thyroid gland was examinated in randomly selected population (n = 1 055, 360 male, 695 female) in 11 regions of the Czech republic, all presented with urinary iodine concentration > 100 microg/L of urine. The echogenity was determined in 4-level scale as increased (1), normal (0), mildly decreased (-1) and significantly decreased (-2). Texture of thyroid was evaluated in 2-level scale as homogenous or non-homogenous. For the evaluation of the relation between echogenity type (1 to -2) and TgAb, and between the type of echogenity and TOPAb frequence analysis (logarithm-linear modules) was used, i.e. the complete module was compared with the measured values. RESULTS: The selected adults (695 female, 360 male) with urinary iodine concentration > 100 microg/L of urine presented with increased echogenity in 2 females (0.28%) and 1 male (0.28%), normal echogenity in 281 females (40.42%) and 206 males (57.22%), mildly decreased echogenity in 288 females (41.43%) and 128 males (35.56%) and significantly decreased echogenity in 124 females (17.84%) and 25 males (6.95%). The biggest group, both in males and in females, presented with normal and mildly decreased echogenity. Homogenous thyroid gland structure was found in 223 females (32.08%) and 220 males (61.11%). Non-homogenous texture was found in 472 females (67.92 %) and 140 males (38.89%). Frequence analysis both in males and in females was focused on: 1. relation between the echogenity (ECHO) and TgAb: in females with positive TgAb (14.23%), significant relation to ECHO can be seen (p < 0,0001), in contradiction to males; 2. relation between the echogenity (ECHO) and TPOAb: this relation is very significant both in males and in females (p < 0.0001); 3. mutual relation between TgAb and TPOAb: both in males and in females very significant (p < 0.0001); positive relation between antibodies can be seen. Positive presence of antibodies can be found less frequent, negative presence of both antibodies is more frequent; 4. relation between the echogenity, TgAb and TPOAb: no statistic significance was found. CONCLUSION: Homogenous thyroid gland structure was mainly found in males and, on the contrary, non-homogenous structure in females. In 52.7% of adults with significantly decreased echogenity, autoimmune disorder was confirmed in laboratory tests at the same time. With echogenity increasing, TgAb and TPOAb decreased, vice versa. Sonography, evaluating decreased echogenity, can be an early indicator of serious thyropathies before function parameters and clinical symptoms appear. Detected risky adults with sonographic signs of autoimmune disorder have to be monitored and respective treatment considered and started at the very first occurence of positive antibodies even if the function is still normal.

• MeSH
• autoimunitní nemoci diagnostické zobrazování   imunologie   moč   MeSH
• autoprotilátky analýza   MeSH
• dospělí MeSH
• jod moč   MeSH
• lidé MeSH
• nemoci štítné žlázy diagnostické zobrazování   imunologie   moč   MeSH
• štítná žláza diagnostické zobrazování   imunologie   MeSH
• ultrasonografie MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• autoprotilátky MeSH
• jod MeSH

Presented herein is the case of a 65-year-old man with a 20 year history of thyroid hypofunction. On sonography a cystic lesion 4 x 4 x 5 cm in largest diameter was found, replacing most of the right lobe of the thyroid gland. Microscopically, the lesion was composed of labyrinth-like cystic structures (LCS) lined by a few layers of benign-appearing squamous cells and filled by mucinous material. Adjacent to the cyst walls were discontinuous patches of a lymphoid tissue, composed of haloed centrocyte-like cells or germinal centers mostly depleted of germinal cells. Additionally, there were numerous squamous cell nests equivalent to solid cell nests (SCN), all of which were surrounded by a similar-looking lymphoid tissue. Rare SCN were thus cystically changed and contained a small amount of mucus. The SCN communicated with the LCS: the former represented the most distal outpouchings of the latter. The epithelial structures were surrounded by a loose collagenous adipocytic stroma with plump fibroblasts, which resembled the stroma often seen in lateral neck cysts associated with structures such as cartilage, accessory salivary gland tissues, cysts and accessory thyroid and thymus. Immunohistochemically, all lesional elements were negative for calcitonin and thyroglobulin. The results of the paper suggest that branchial cleft-like cyst have an origin in the ultimobranchial body.

• MeSH
• branchiom patologie   MeSH
• cysty diagnostické zobrazování   patologie   MeSH
• imunohistochemie MeSH
• lidé MeSH
• nádory štítné žlázy patologie   MeSH
• nemoci štítné žlázy diagnostické zobrazování   patologie   MeSH
• senioři MeSH
• ultrasonografie MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

Ultrasonography is a generally accepted method for diagnosing both the diffuse and focal (nodal) lesions of the thyroid gland. The main limit of this method is the restricted ability of the human eye to analyse all information included. Moreover, the proportion of subjectivity when evaluating the picture is greater than with other imaging methods. Computer texture analysis in combination with automatic classification may prove a potent tool that could enable--immediately after the standard examination--to assign the finding to a particular type of diffuse disorder, with an accuracy of up to 100 percent. From a variety of procedures, which we have tested until now, the best results were obtained with a combination of spatial, co-occurrence and systematically constructed features, selected by a method that is based on the magnitude of classification error. From several tested ways of classification the Bayes's classificator in combination with the criterion of majority was found to be the best approach.

• MeSH
• lidé MeSH
• nemoci štítné žlázy diagnostické zobrazování   MeSH
• počítačové zpracování obrazu * MeSH
• ultrasonografie metody   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH

UNLABELLED: After 45 years of successful iodine prophylaxis a total of 6324 subject aged 7 to 70 years from East (72.0%), Central (16.2%) and West Slovakia (11.8%) were examined. The thyroid volume (ThV) by ultrasound was examined in a total of 6045 subjects. Serum level of thyrotropin (TSH) was estimated in 1919 (30.3%) and anti-thyroperoxidase antibodies (anti-TPO) in 2589 (40.9%) subjects. Iodine was estimated in 1983 (31.3%) spot urine samples. The median and 75th percentile of ThV were increasing (respectively) from 3.9 and 5.2 ml (10 yr), 8.2 and 10.2 ml (17 yr), 12.4 and 16.3 ml (31-40 yr) up to 14.1 and 19.9 ml (61-70 yr). The frequency of ultrasound hypoechogenicity as an early sign of autoimmune thyroiditis increased from 3.9% (28/709; 10 yr), 16.3% (66/403; 21-40 yr) and 30.3% (205/665; 41-60 yr) up to 51.0% (48/94; 61-70 yr). Positive anti-TPO level as an other sign of autoimmune thyroiditis was found in 1.6% (11/683; 7-13 yr), 7.3% (47/644; 17-30 yr) and 20.4% (257/1262; 31-70 yr). In the adults 19.0% (268/1409) positive anti-TPO were found. Among 1367 adults 6.2% (N = 85) of TSH levels were higher than 4.0 mU/l and 7.5% (N = 103) were lower than 0.2 mU/l. Among 1504 adults a total of 93 (6.1%) of nodules larger than 10 mm in diameter was found (14 in males and 75 in females). In this study the nature of nodules remained unidentified, since all subjects were referred to additional examinations. Malignant nodules were suspected in 3 females with high serum thyroglobulin level and in one additional female with occasionally found very large nodule. The estimation of urinary iodine showed a majority of values in optimal range (> 100-200 microg/l). CONCLUSIONS: Thyroid volume in about 75% examined subjects of all age groups may be considered as relatively small which is apparently due to 45 years of effective iodine prophylaxis. In spite of that the volume of remaining about 25% thyroids were apparently increased which may be presubambly explained by the effect of mainly genetic, but also environmental factors.

• MeSH
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• nemoci štítné žlázy diagnóza   diagnostické zobrazování   epidemiologie   MeSH
• senioři MeSH
• štítná žláza diagnostické zobrazování   MeSH
• ultrasonografie MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Slovenská republika epidemiologie   MeSH