Subscribe to RSS
DOI: 10.1055/s-0029-1237700
© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York
Does Normal Thyroid Gland by Ultrasonography match with Normal Serum Thyroid Hormones and Negative Thyroid Antibodies?
Publication History
received 02.04.2009
first decision 10.06.2009
accepted 30.07.2009
Publication Date:
08 December 2009 (online)
![](https://www.thieme-connect.de/media/eced/201009/lookinside/thumbnails/10.1055-s-0029-1237700-1.jpg)
Abstract
Few papers have shown that a hypoechoic appearance of the thyroid gland at ultrasonography (US) is related to a hypofunction and serum positivity of thyroid antibodies (T-Ab). However, it is not ascertained if normal thyroid appearance at US correspond to normal thyroid laboratory tests. The aim of this study was to assess the value of normal thyroid at US in predicting normal thyroid hormones and negative T-Ab in a cohort of 48 adult patients. All patients (37 females and 11 males) were referred to our hospital to undergo their first thyroid US examination, followed by a thyroid function evaluation. All subjects had normal thyroid gland at US. As a control group 65 patients with hypoechoic and inhomogeneous thyroid gland were enrolled. All 48 patients had normal free-T3 and free-T4 levels. While 41 patients (85.4%) showed normal TSH, in 7 subjects (14.6%) TSH was elevated and a significant (p<0.001) difference was recorded between the two groups in mean TSH value. Positive T-Ab value was found in 5 patients (10.4%) and the remaining 43 patients (89.6%) had negative T-Ab. TSH was not significantly correlated with age, thyroid volume or BMI. The multivariate model showed that only BMI was significantly correlated to thyroid volume (p<0.01, r2=0.31). These results showed that normal thyroid recorded by US matches with normal thyroid laboratory assessment to a large degree. These preliminary data need to be confirmed in a prospective study and in a larger series and should suggest the evaluation of thyrotropin and thyroid antibodies in subjects with normal thyroid gland as assessed by US.
Key words
thyroid ultrasonography - thyroid function - serum thyroid hormones - thyroid antibodies
References
- 1 Brunn J, Block U, Ruf G. et al . Volumetric analysis of thyroid lobes by real-time ultrasound. Dtsch Med Wochenschr. 1981; 106 1338-1340
- 2 Díez JJ, Iglesias P, Burman KD. Spontaneous normalization of thyrotropin concentrations in patients with subclinical hypothyroidism. J Clin Endocrinol Metab. 2005; 90 4124-4127
- 3 Díez JJ, Iglesias P. Spontaneous subclinical hypothyroidism in patients older than 55 years: an analysis of natural course and risk factors for the development of overt thyroid failure. J Clin Endocrinol Metab. 2004; 89 4890-4897
- 4 Marcocci C, Vitti P, Cetani F. et al . Thyroid ultrasonography helps to identify patients with diffuse lymphocytic thyroiditis who are prone to develop hypothyroidism. J Clin Endocrinol Metab. 1991; 72 209-213
- 5 Rago T, Chiovato L, Grasso L. et al . Thyroid ultrasonography as a tool for detecting thyroid autoimmune diseases and predicting thyroid dsfunction in apparently healthy subjects. J Endocrinol Invest. 2001; 24 763-769
- 6 Rago T, Di Coscio G, Ugolini C. et al . Clinical features of thyroid autoimmunity are associated with thyroiditis on histology and are not predictive of malignancy in 570 patients with indeterminate nodules on cytology who had a thyroidectomy. Clin Endocrinol (Oxf). 2007; 67 363-369
- 7 Rosário PW, Bessa B, Valadão MM. et al . Natural history of mild subclinical hypothyroidism: prognostic value of ultrasound. Thyroid. 2009; 19 9-12
- 8 Trimboli P, Ruggieri M, Fumarola A. et al . A mathematical formula to estimate in vivo thyroid volume from two-dimensional ultrasonography. Thyroid. 2008; 18 879-882
- 9 Vitti P, Rago T. Thyroid ultrasound as a predicator of thyroid disease. J Endocrinol Invest. 2003; 26 686-689
- 10 WHO, ICCIDD . Recommended normative values for thyroid volume in children aged 6-15 years. Bullettin WHO. 1997; 75 95-97
- 11 World Health Organization .Indicators for assessing iodine deficiency disorders and their control through salt iodization. Geneva, Switzerland: World Health Organization; 1994 (document no. WHO/NUT94.6)
Correspondence
Dr. P. Trimboli
Ospedale Israelitico di Roma
Via Fulda, 14
00148 – Rome, Italy
Phone: +39-06-655891
Fax: +39-06-655891
Email: pierpaolo.trimboli@gmail.com