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Yuan J, Qi S, Zhang X, Lai H, Li X, Xiaoheng C, Li Z, Yao S, Ding Z. Local symptoms of Hashimoto's thyroiditis: A systematic review. Front Endocrinol (Lausanne) 2022; 13:1076793. [PMID: 36743914 PMCID: PMC9892448 DOI: 10.3389/fendo.2022.1076793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 12/22/2022] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE Hashimoto's thyroiditis (HT) is the most common type of thyroid disease and can cause many different manifestations. The local symptoms of HT are an under-studied area of research. Therefore, the purpose of this study was to investigate the local symptoms of HT and their prevalence. METHODS A systematic review was performed to find articles in PubMed that discuss the local symptoms of HT. Relevant vocabulary terms and key terms included: autoimmune thyroid disease (AITD), hyperthyroidism, hypothyroidism, neck, throat, pharynx, airway, esophagus, breathe, swallow, globus, sleep apnea, symptoms, and quality of life. Two investigators independently screened the eligible studies. RESULTS A total of 54 articles fulfilled the inclusion criteria. Of these, 25 were clinical studies, 24 were case reports, and five were reviews. These clinical studies and case reports included a total of 2660 HT patients. There were eight local symptoms related to HT: neck pain (0.02%~16%), voice changes (7%~30%), throat discomfort (20%~43.7%), shortness of breath (28%~50%), dysphagia (29%), goiter-related symptoms (69.44%), sleep apnea, and generally defined compressive symptoms. Due to the use of different outcome measures among all the studies, a meta-analysis of the data could not be performed. CONCLUSION Goiter symptoms, which are an item on the ThyPRO scales, are the most frequent local symptoms in HT patients, and include neck pain, voice changes, throat discomfort, and dysphagia. These local symptoms should be identified in the clinic and included in the early diagnosis and management of HT, as well as evaluated further to understand their relevance in the pathogenesis of HT.
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Affiliation(s)
- Jiaojiao Yuan
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
- The First Clinical Medical College, Beijing University of Chinese Medicine, Beijing, China
| | - Shuo Qi
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
- Sunsimiao Hospital, Beijing University of Chinese Medicine, Tongchuan, Shanxi, China
- *Correspondence: Shuo Qi, ; Zhiguo Ding,
| | - Xufan Zhang
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
- The First Clinical Medical College, Beijing University of Chinese Medicine, Beijing, China
| | - Hezheng Lai
- National Institute of Complementary Medicine, Western Sydney University, Westmead, NSW, Australia
| | - Xinyi Li
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
- The First Clinical Medical College, Beijing University of Chinese Medicine, Beijing, China
| | - Chen Xiaoheng
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Zhe Li
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Simiao Yao
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
- The First Clinical Medical College, Beijing University of Chinese Medicine, Beijing, China
| | - Zhiguo Ding
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
- Sunsimiao Hospital, Beijing University of Chinese Medicine, Tongchuan, Shanxi, China
- *Correspondence: Shuo Qi, ; Zhiguo Ding,
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Yamaguchi T. Basic concept and clinical applications of quantitative ultrasound (QUS) technologies. J Med Ultrason (2001) 2021; 48:391-402. [PMID: 34669072 PMCID: PMC8578064 DOI: 10.1007/s10396-021-01139-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 07/26/2021] [Indexed: 01/01/2023]
Abstract
In the field of clinical ultrasound, the full digitalization of diagnostic equipment in the 2000s enabled the technological development of quantitative ultrasound (QUS), followed by multiple diagnostic technologies that have been put into practical use in recent years. In QUS, tissue characteristics are quantified and parameters are calculated by analyzing the radiofrequency (RF) echo signals returning to the transducer. However, the physical properties (and pathological level structure) of the biological tissues responsible for the imaging features and QUS parameters have not been sufficiently verified as there are various conditions for observing living tissue with ultrasound and inevitable discrepancies between theoretical and actual measurements. A major issue of QUS in clinical application is that the evaluation results depend on the acquisition conditions of the RF echo signal as the source of the image information, and also vary according to the model of the diagnostic device. In this paper, typical examples of QUS techniques for evaluating attenuation, speed of sound, amplitude envelope characteristics, and backscatter coefficient in living tissues are introduced. Exemplary basic research and clinical applications related to these technologies, and initiatives currently being undertaken to establish the QUS method as a true tissue characterization technology, are also discussed.
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Affiliation(s)
- Tadashi Yamaguchi
- grid.136304.30000 0004 0370 1101Center for Frontier Medical Engineering, Chiba University, 1-33 Yayoicho, Inage, Chiba 2638522 Japan
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Lee JM, Ha J, Jo K, Lim Y, Kim MH, Jung CK, Jung SL, Kang MI, Cha BY, Lim DJ. Risk factors for hypothyroidism in euthyroid thyroid nodule patients with lymphocytic thyroiditis on fine needle aspiration cytology. Korean J Intern Med 2019; 34. [PMID: 29529842 PMCID: PMC6823571 DOI: 10.3904/kjim.2017.177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/AIMS Lymphocytic thyroiditis as cytology diagnosis from fine needle aspiration (FNA) is frequently detected in patients with thyroid nodules. However, the clinical outcome for upcoming hypothyroid events has been rarely clarified in euthyroid patients. METHODS We retrospectively reviewed the data of patient who had lymphocytic thyroitidis on FNA cytology of thyroid nodule from January 2005 to December 2010 at a tertiary referral hospital. In total, 109 patients with follow-up thyroid function tests (TFT) were enrolled. Final outcomes included overt and subclinical hypothyroidism with thyroid stimulating hormone (TSH) levels ≥ 10 mIU/L. Potential parameters predicting clinical hypothyroidism were analyzed by multivariate analysis. RESULTS Over the mean follow-up duration of 51.6 months, 14 out of 109 patients (12.8%) developed clinical hypothyroidism that required thyroid hormone replacement. The median onset time to hypothyroidism was 16 months (range, 3 to 88) and ≥ 60% of patients experienced clinical hypothyroidism within 1 year. By multivariate analysis, background thyroiditis (relative risk [RR], 9.78; p = 0.004), thyroid peroxidase antibody positivity (RR, 9.90; p = 0.003), nodule size (RR, 1.24; p < 0.001), and initial TSH (RR, 1.47; p = 0.009) were the independent risk factors for predicting hypothyroidism in euthyroid patients. CONCLUSION Hypothyroidism frequently occurs during the follow-up in euthyroid patients with thyroid nodules which show lymphocytic thyroiditis on FNA cytology. Close surveillance and regular TFT are needed in high-risk patients for upcoming clinical hypothyroidism.
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Affiliation(s)
- Jeong-Min Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Jeonghoon Ha
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Kwanhoon Jo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Yejee Lim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Min-Hee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Chan-Kwan Jung
- Department of Pathology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - So-Lyung Jung
- Department of Radiology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Moo-Il Kang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Bong-Yun Cha
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Dong-Jun Lim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
- Correspondence to Dong-Jun Lim, M.D. Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea Tel: +82-2-2258-6009 Fax: +82-2-599-3589 E-mail:
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Lee JY, Hong HS, Kim CH. Prognostic value of acoustic structure quantification in patients with Hashimoto’s thyroiditis. Eur Radiol 2019; 29:5971-5980. [DOI: 10.1007/s00330-019-06174-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 03/04/2019] [Accepted: 03/15/2019] [Indexed: 02/06/2023]
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Summers SM, Chin EJ, April MD, Grisell RD, Lospinoso JA, Kheirabadi BS, Salinas J, Blackbourne LH. Diagnostic accuracy of a novel software technology for detecting pneumothorax in a porcine model. Am J Emerg Med 2017; 35:1285-1290. [PMID: 28400069 DOI: 10.1016/j.ajem.2017.03.073] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 03/21/2017] [Accepted: 03/30/2017] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION Our objective was to measure the diagnostic accuracy of a novel software technology to detect pneumothorax on Brightness (B) mode and Motion (M) mode ultrasonography. METHODS Ultrasonography fellowship-trained emergency physicians performed thoracic ultrasonography at baseline and after surgically creating a pneumothorax in eight intubated, spontaneously breathing porcine subjects. Prior to pneumothorax induction, we captured sagittal M-mode still images and B-mode videos of each intercostal space with a linear array transducer at 4cm of depth. After collection of baseline images, we placed a chest tube, injected air into the pleural space in 250mL increments, and repeated the ultrasonography for pneumothorax volumes of 250mL, 500mL, 750mL, and 1000mL. We confirmed pneumothorax with intrapleural digital manometry and ultrasound by expert sonographers. We exported collected images for interpretation by the software. We treated each individual scan as a single test for interpretation by the software. RESULTS Excluding indeterminate results, we collected 338M-mode images for which the software demonstrated a sensitivity of 98% (95% confidence interval [CI] 92-99%), specificity of 95% (95% CI 86-99), positive likelihood ratio (LR+) of 21.6 (95% CI 7.1-65), and negative likelihood ratio (LR-) of 0.02 (95% CI 0.008-0.046). Among 364 B-mode videos, the software demonstrated a sensitivity of 86% (95% CI 81-90%), specificity of 85% (81-91%), LR+ of 5.7 (95% CI 3.2-10.2), and LR- of 0.17 (95% CI 0.12-0.22). CONCLUSIONS This novel technology has potential as a useful adjunct to diagnose pneumothorax on thoracic ultrasonography.
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Affiliation(s)
- Shane M Summers
- Department of Emergency Medicine, San Antonio Military Medical Center, JBSA Fort Sam Houston, TX, USA
| | - Eric J Chin
- Department of Emergency Medicine, San Antonio Military Medical Center, JBSA Fort Sam Houston, TX, USA
| | - Michael D April
- Department of Emergency Medicine, San Antonio Military Medical Center, JBSA Fort Sam Houston, TX, USA.
| | - Ronald D Grisell
- United States Army Institute of Surgical Research, JBSA Fort Sam Houston, TX, USA
| | - Joshua A Lospinoso
- Department of Emergency Medicine, San Antonio Military Medical Center, JBSA Fort Sam Houston, TX, USA
| | - Bijan S Kheirabadi
- United States Army Institute of Surgical Research, JBSA Fort Sam Houston, TX, USA
| | - Jose Salinas
- United States Army Institute of Surgical Research, JBSA Fort Sam Houston, TX, USA
| | - Lorne H Blackbourne
- United States Army Medical Department Center and School (AMEDD C&S), JBSA Fort Sam Houston, TX, USA
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Jeong SH, Hong HS, Lee EH. Diagnostic Utility of Acoustic Structure Quantification for Evaluation of Radiation Sialadenitis after Radioactive Iodine Therapy. ULTRASOUND IN MEDICINE & BIOLOGY 2016; 42:2553-2561. [PMID: 27543124 DOI: 10.1016/j.ultrasmedbio.2016.06.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 05/27/2016] [Accepted: 06/26/2016] [Indexed: 06/06/2023]
Abstract
Acoustic structure quantification (ASQ) software was used to analyze statistical information on acquired echo signals, to determine the ability of ASQ to distinguish normal salivary glands of asymptomatic patients from glands of patients with radiation sialadenitis (RS) after radioactive iodine therapy. The ASQ values of 192 salivary glands were compared by multinomial logistic regression analysis, and receiver operating characteristic curves were constructed. Between-observer agreement was assessed by calculating the intra-class correlation coefficient. The mean ASQ values of patients with chronic RS or asymptomatic patients who had undergone radioactive iodine therapy were greater than those of patients with normal glands (p < 0.001). The ratio was associated with the highest odds ratio in patients with chronic RS compared with normal patients. Diagnostic performance was moderate; the intra-class correlation coefficient between observers was very good. ASQ can objectively differentiate RS-affected tissue from normal salivary tissue and is thus valuable for clinically diagnosing RS after radioactive iodine therapy.
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Affiliation(s)
- Sun Hye Jeong
- Department of Radiology, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
| | - Hyun Sook Hong
- Department of Radiology, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea.
| | - Eun Hye Lee
- Department of Radiology, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
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