Abstract
In this study, we aimed to evaluate thyroid ultrasonography findings of patients, who had normal physical thyroid examination and no history of any thyroid disease, consulted to our thyroid policlinics. Six hundred thirty two patients were included. Thyroid ultrasonographies and examinations were performed by an expert at the same day. Thyroid parenchyma was determined as homogeneous or heterogeneous (mild, moderate, severe). The number of detected thyroid nodules, their sizes and localizations were recorded, each. The sera of patients were analysed for fT3, fT4,
TSH, AntiTPO Ab and AntiTg Ab serum levels. The mean age of the study group was 40,7± 13,88 years. Of all the cases; 86.8 % were female and 13.2 % were male. Of the patients, 460 (72.%) were euthyroid, 44 (7.0%) were subclinical hypothyroid, 79 (12.5%) were subclinical hyperthyroid, 28 (4.4%) were hypothyroid and 21 (3.3%) were in hyperthyroid. After the ultrasonographic evaluation, it was seen that 296 (46.8%) cases were found to have a normal thyroid gland,; 165 (26.1%) had thyroiditis, 74 (11.7%) had nodulary goitre (NG), 46 (7.3%) had multi-nodulary goitre (MNG), 35 (5.7%) had NG + Thyroiditis and 15 (2.4%) had MNG + Thyroiditis. In our country where the prevalence of thyroid diseases is guite high, it is possible to overlook many thyroid nodules and pathologies by palpation alone. Therefore, we find it important to scan the thyroid gland by ultrasonography and evaluate serum thyroid function test seven if the physical examination findings are normal.
Keywords
References
- 1. WHO, UNICEF & ICCIDD. Indicators for as-sessing iodine deficiency disorders and their control through salt iodization. WHO/NUT/ 94.6. Geneva: WHO 1994.
- 2. Delande F, Benker G, Caron P, et al. Thyroid volume and urinary iodine in European schoolchildren: standardization of values for assessment of iodine deficiency. Eur J Endocrinol 1997, 136: 180- 87.
- 3. Peterson S, Sanga A, Eklöf H, et al. Classification of thyroid size by palpation and ultrasonography in field surveys. Lancet 2000, 355: 106- 10.
- 4. Zimmermann M, Saad A, Hess S, Torresani T, Chaouki N. Thyroid ultrasound compared with World Health Organization 1960 and 1994 palpation criteria for determination of goiter prevalance in regions of mild and severe iodine deficiency. Eur J Endocrinol 2000, 143: 727-31.
- 5. Vıtti P, Martino E, Aghini- Lombardini F, et al. Thyroid volume measurement by ultrasound in children as a tool for the assessment of mild iodine deficiency. J Clin Endocrinol Metab 1994, 79: 600- 3.
- 6. Gutekunst R, Martin- Teichert H. Requir-ments for goiter surveys and the determination of thyroid size. In iodine deficiency in Europe: a continuing concern, pp. 109- 18. Ed F. Delange, JT Dunn, D Glioner. New York: Plenum Pres, 1993.
- 7. Tan GH, Gharib H, Reading CC. Solitary thyroid nodule: Comparison between palpation and ultrasonography. Arch Intern Med 1995, 155: 2418- 23.
- 8. Brander A, Viikinkoski P, Tuuhea J, Voutilain-en L, Kivisaari L. Clinical versus ultrasound examination of the thyroid gland in common clinical practice. J Clin Ultrasound 1992, 20: 37- 42.
- 9. Marqusee E, Benson CB, Frates MC, et al. Usefullness of ultrasonography in the management of nodular thyroid disease. Ann Intern Med 2000, 133: 696- 700.
- 10. Burguera B, Gharib H. Thyroid incidentalo-mas prevalance, diagnosis, significance and management. Endocrinol Metab Clin North Am, 2000, 29:187-203.
- 11. Rojeski MT, Gharib H. Nodular thyroid disease: Evaluation and management . N Engl J Med 1985, 313: 428.
- 12. Tan GH, Gharib H. Thyroid incidentalomas, Management approaches to non-palpable nodules discovered incidentally on thyroid imaging. Ann Intern Med 1997, 126: 226.
- 13. Brander A, Viikinkoski P, Nickels J, Kivisaari L. Thyroid gland: US screening in a random adult population. Radiology, 1991, 181: 683-87.
- 14. Walsh RM, Watkinson JC, Franklyn J. The management of the solitary thyroid nodule: a review. Clin Otolaryngol Allied Sci. 1999, 24: 388.
- 15. Mazzeferri EL. Management of a solitary thyroid nodule. N Eng J Med 1993, 328(8): 553- 59.
- 16. Supit E, Peiris AN. Cost- effective Management of Thyroid Nodules and Nodular Thy-roid Goiters Southern Medical Journal, May 2002, 95: 5.
- 17. Gharib H, Papini E, Thyroid Nodules: Clinical Importance, Assesment and Treatment, Endocrinol Metab Clin North Am. 2007, 36(3): 707- 35.
- 18 Erdoğan MF. Tiroid nodülleri ve tedavisi. Endokrinolojide Diyalog. 2006, 2(2).
- 19. Urgancıoğlu İ, Hatemi H, Uslu I, et al. En-demik guatr taramalarının değerlendirilmesi, klinik gelişim. 1987: 36- 8.
- 20. Urgancıoğlu I, Hatemi H. Yenici O, et al. Türkiye’ de endemik guatr. Cerrahpaşa Tıp Fakültesi Nükleer Tıp Ana Bilim Dalı yayın no: 14. İstanbul. 1988, 9- 40.
- 21. Erdoğan G, Erdoğan MF, Emral R, Baştemir M, Sav H, et al. Iodine status and goiter prevalance in Turkey before mandatory iodization. J Endocrinol Invest. 2002, 25: 224- 228.
- 22. Bruneton JN, Balu-Maestro C, Marcy PY, Melia P, Mourou MY. Very high frequency (13MHz) ultrasonographic examination of the normal neck: detection of normal lymph nodes and thyroid nodules. Journal of Ultrasound Medicine. 1994, 13: 87- 90.
- 23. Mortensen JD, Woolner LB, Bennett WA. Gross and microscopic findings in clinically normal thyroid glands. Journal of clinical endocrinology. 1995, 15: 1270- 75.
Abstract
Bu çalışmada tiroid polikliniğimize başvuran, daha önce bilinen tiroid hastalığı öyküsü olmayan ve tiroid muayenesi normal olan hasta grubunu tiroid ultrasonografi (US) bulguları ile değerlendirmeyi amaçladık. Çalışmaya 632 hasta alındı. Tiroid US, deneyimli bir uzman tarafından muayene ile aynı gün yapıldı. Tiroid parankimi homojen veya değişik derecelerde heterojen (hafif, orta, ileri derecede) olarak değerlendirildi. US ile saptanan nodüllerin sayı, boyut ve lokalizasyon-ları kaydedildi. Hastaların serum örneklerinde sT3, sT4, TSH, Anti TPO Ab ve Anti Tg Ab düzeyleri çalışıldı.
Çalışmaya alınan 632 olgunun yaş ortalaması 40,7±13,88 (yıl) olarak saptandı. Olguların %86,8’ i kadınlardan, %13,2’ si erkeklerden oluşmaktaydı. US’ ye göre yapılan sınıflamaya göre olguların 296’ sı (%46,8) normal, 165’ i (%26,1) tiroidit, 74’ ü (%11,7) nodüler guatr (NG), 46’ sı (%7,3) multinodüler guatr (MNG), 35’ i (%5.7) NG + Tiroidit ve 15 (%2,4) MNG + Tiroidit gubunda yer almaktaydı. Olguların 460’ ı (%72,8) ötiroid, 44’ ü (%7,0) subklinik hipotiroid, 79’ u (%12,5) subklinik hipertiroid, 28’ i (%4,4) hipotiroid, 2T i (%3,3) hipertiroid idi.
Tiroid hastalıkları prevalansının yüksek görüldüğü ülkemizde palpasyon ile çok fazla nodül ve patoloji gözden kaçabilmektedir. Bu nedenle fizik muayene bulguları normal bulunsa bile US ile tiroid bezi görüntülenmen ve US sonuçları tiroid fonksiyon testleri ile desteklenmelidir.
Dr. Ünal KILIÇ
Dr. Tuncer KILIÇ
Dr. Atilla AYBAR
Dr. Emel Özge KARAKAYA
Dr. Halil Fehmi ÇATMA
Dr. Reyhan ERSOY
Dr. Bekir ÇAKIR
Keywords
References
- 1. WHO, UNICEF & ICCIDD. Indicators for as-sessing iodine deficiency disorders and their control through salt iodization. WHO/NUT/ 94.6. Geneva: WHO 1994.
- 2. Delande F, Benker G, Caron P, et al. Thyroid volume and urinary iodine in European schoolchildren: standardization of values for assessment of iodine deficiency. Eur J Endocrinol 1997, 136: 180- 87.
- 3. Peterson S, Sanga A, Eklöf H, et al. Classification of thyroid size by palpation and ultrasonography in field surveys. Lancet 2000, 355: 106- 10.
- 4. Zimmermann M, Saad A, Hess S, Torresani T, Chaouki N. Thyroid ultrasound compared with World Health Organization 1960 and 1994 palpation criteria for determination of goiter prevalance in regions of mild and severe iodine deficiency. Eur J Endocrinol 2000, 143: 727-31.
- 5. Vıtti P, Martino E, Aghini- Lombardini F, et al. Thyroid volume measurement by ultrasound in children as a tool for the assessment of mild iodine deficiency. J Clin Endocrinol Metab 1994, 79: 600- 3.
- 6. Gutekunst R, Martin- Teichert H. Requir-ments for goiter surveys and the determination of thyroid size. In iodine deficiency in Europe: a continuing concern, pp. 109- 18. Ed F. Delange, JT Dunn, D Glioner. New York: Plenum Pres, 1993.
- 7. Tan GH, Gharib H, Reading CC. Solitary thyroid nodule: Comparison between palpation and ultrasonography. Arch Intern Med 1995, 155: 2418- 23.
- 8. Brander A, Viikinkoski P, Tuuhea J, Voutilain-en L, Kivisaari L. Clinical versus ultrasound examination of the thyroid gland in common clinical practice. J Clin Ultrasound 1992, 20: 37- 42.
- 9. Marqusee E, Benson CB, Frates MC, et al. Usefullness of ultrasonography in the management of nodular thyroid disease. Ann Intern Med 2000, 133: 696- 700.
- 10. Burguera B, Gharib H. Thyroid incidentalo-mas prevalance, diagnosis, significance and management. Endocrinol Metab Clin North Am, 2000, 29:187-203.
- 11. Rojeski MT, Gharib H. Nodular thyroid disease: Evaluation and management . N Engl J Med 1985, 313: 428.
- 12. Tan GH, Gharib H. Thyroid incidentalomas, Management approaches to non-palpable nodules discovered incidentally on thyroid imaging. Ann Intern Med 1997, 126: 226.
- 13. Brander A, Viikinkoski P, Nickels J, Kivisaari L. Thyroid gland: US screening in a random adult population. Radiology, 1991, 181: 683-87.
- 14. Walsh RM, Watkinson JC, Franklyn J. The management of the solitary thyroid nodule: a review. Clin Otolaryngol Allied Sci. 1999, 24: 388.
- 15. Mazzeferri EL. Management of a solitary thyroid nodule. N Eng J Med 1993, 328(8): 553- 59.
- 16. Supit E, Peiris AN. Cost- effective Management of Thyroid Nodules and Nodular Thy-roid Goiters Southern Medical Journal, May 2002, 95: 5.
- 17. Gharib H, Papini E, Thyroid Nodules: Clinical Importance, Assesment and Treatment, Endocrinol Metab Clin North Am. 2007, 36(3): 707- 35.
- 18 Erdoğan MF. Tiroid nodülleri ve tedavisi. Endokrinolojide Diyalog. 2006, 2(2).
- 19. Urgancıoğlu İ, Hatemi H, Uslu I, et al. En-demik guatr taramalarının değerlendirilmesi, klinik gelişim. 1987: 36- 8.
- 20. Urgancıoğlu I, Hatemi H. Yenici O, et al. Türkiye’ de endemik guatr. Cerrahpaşa Tıp Fakültesi Nükleer Tıp Ana Bilim Dalı yayın no: 14. İstanbul. 1988, 9- 40.
- 21. Erdoğan G, Erdoğan MF, Emral R, Baştemir M, Sav H, et al. Iodine status and goiter prevalance in Turkey before mandatory iodization. J Endocrinol Invest. 2002, 25: 224- 228.
- 22. Bruneton JN, Balu-Maestro C, Marcy PY, Melia P, Mourou MY. Very high frequency (13MHz) ultrasonographic examination of the normal neck: detection of normal lymph nodes and thyroid nodules. Journal of Ultrasound Medicine. 1994, 13: 87- 90.
- 23. Mortensen JD, Woolner LB, Bennett WA. Gross and microscopic findings in clinically normal thyroid glands. Journal of clinical endocrinology. 1995, 15: 1270- 75.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Endocrinology |
| Journal Section | Research Article |
| Authors | |
| Publication Date | November 22, 2010 |
| Published in Issue | Year 2010 Volume: 4 Issue: 3 |
