• JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
 
  Bookmark and Share
 
 
Doctoral Thesis
DOI
10.11606/T.5.2017.tde-07082017-091322
Document
Author
Full name
Thiago Adler Ralho Rodrigues dos Santos
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2017
Supervisor
Committee
Chammas, Maria Cristina (President)
Macedo, Tulio Augusto Alves
Marui, Suemi
Sapienza, Marcelo Tatit
Souza, Ricardo Pires de
Title in Portuguese
US-Doppler colorido da glândula tireoide, em pacientes com doença de Graves, antes e após radioiodoterapia (131I): correlação com quadro clínico-laboratorial
Keywords in Portuguese
Doença de Graves
Glândula tireoide
Hipertireoidismo
Radioiodoterapia (131I)
Ultrassom
Ultrassonografia Doppler
Abstract in Portuguese
INTRODUÇÃO: A doença de Graves (DG), juntamente com a tireoidite de Hashimoto, compõe as doenças endócrinas autoimunes mais comuns, atingindo cerca de 5% da população. Entre as opções terapêuticas para o tratamento do hipertireoidismo induzido pela DG, encontram-se as drogas antitireoidianas, o iodo radioativo (131I) e a cirurgia. A ultrassonografia Doppler (US-Doppler) como parâmetro de resposta ao tratamento da DG pode ser muito útil e foi pouco pesquisada no acompanhamento do tratamento por radioiodo. OBJETIVO: O objetivo do presente estudo foi avaliar a eficácia da US-Doppler no acompanhamento dos pacientes com DG que foram tratados com iodo radioativo, correlacionando com o quadro clínico-laboratorial da doença. MÉTODOS: Estudo prospectivo em que foram avaliados 97 pacientes com diagnóstico confirmado de DG e tratados com o radioiodo. O estudo foi conduzido no Instituto de Radiologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, de junho de 2011 à agosto de 2015. Todos os indivíduos foram submetidos aos testes laboratoriais e à US-Doppler pré e pós-dose terapêutica de 131I, com 1, 3 e 6 meses, quando foram aferidos o volume tireoidiano e a velocidade de pico sistólico (VPS) nas artérias tireóideas inferiores (ATIs). Além disso, procedeu-se uma avaliação subjetiva da ecogenicidade, textura e vascularização difusa do parênquima tireoidiano. RESULTADOS: Nos parâmetros objetivos pós-intervenção, verificou-se correlação estatisticamente significativa (P < 0,001) da normalização do volume tireoidiano e das VPSs das ATIs com os dados laboratoriais. Já os parâmetros subjetivos de ecogenicidade e vascularização do parênquima, embora tenham apresentado melhora estatisticamente significativa, não tiveram correlação significativa com a normalização dos hormônios tireoidianos. A textura não apresentou alteração. CONCLUSÕES: A US-Doppler se mostrou capaz de monitorar a resposta pós-tratamento com radioiodoterapia de pacientes com DG, por meio da avaliação do volume e das VPSs nas ATIs, podendo predizer, precocemente, a boa resposta ao tratamento
Title in English
Thyroid US-Doppler in patients with Graves' disease before and after radioiodine (131I): correlation with clinical and laboratory evidence
Keywords in English
Color-flow Doppler ultrasonography
Graves disease
Hyperthyroidism
Radioiodinetherapy (131I)
Thyroid gland
Ultrasonics
Abstract in English
INTRODUCTION: Graves' disease (GD), along with Hashimoto's thyroiditis (HT), are the most common autoimmune endocrine disorders, affecting about 5% of the population. Treatment options for hyperthyroidism caused by GD are: antithyroid drugs, radioiodine (131I) and surgery. The use of Doppler ultrasound (US-Doppler) as a response parameter to evaluate the treatment of GD can be very useful and has been poorly researched for monitoring treatment after radioiodine therapy (RIT). AIM: The aim of this study was to assess the effectiveness of US-Doppler for monitoring patients with GD after radioactive iodine therapy, and correlate with the laboratorial diagnosis. METHODS: A prospective study which evaluated 97 patients with confirmed GD who underwent treatment with radioiodine. The study was conducted at the Institute of Radiology of the "Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo" from June 2011 to August 2015. All patients were submitted to laboratory tests, a US-Doppler evaluation before RIT and 1, 3 and 6 months after, in which were measured thyroid volume and systolic peak velocity (SPV) in the lower thyroid arteries (LTAs), and a subjective evaluation of echogenicity, texture and diffuse vascularity of the thyroid parenchyma. RESULTS: In the post-intervention objective parameters, a statistically significant correlation was found (P < 0,001) with the normalization of thyroid volume and SPVs of LTAs with laboratory data. Although the subjective parameters of echogenicity and vascularity of the parenchyma were statistically significant, they did not correlate with thyroid hormones normalization. The texture was not affected. CONCLUSIONS: The USDoppler has demonstrated effectiveness for monitoring response treatment after radioiodine therapy with assessment of gland volume and SPVs in the LTAs, being able to predict, in early stages, good response to treatment
 
WARNING - Viewing this document is conditioned on your acceptance of the following terms of use:
This document is only for private use for research and teaching activities. Reproduction for commercial use is forbidden. This rights cover the whole data about this document as well as its contents. Any uses or copies of this document in whole or in part must include the author's name.
Publishing Date
2017-08-07
 
WARNING: Learn what derived works are clicking here.
All rights of the thesis/dissertation are from the authors
CeTI-SC/STI
Digital Library of Theses and Dissertations of USP. Copyright © 2001-2021. All rights reserved.