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Subacute thyroiditis paranchime heterogeneity may mask thyroid nodules and higher EU-TIRADS scores

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Abstract

Purpose

Nonhomogenous and ill-defined hypoechoic areas are typical ultrasonographic features of subacute thyroiditis (SAT). Evaluating a thyroid nodule accurately in this heterogeneous paranchime may be troublesome. This study aims to compare thyroid nodules, their characteristics, and European Thyroid Imaging and Reporting Data System (EU-TIRADS) categories at the time of the diagnosis and in the remission of SAT.

Methods

Ultrasonographic features of SAT and characteristics and EU-TIRADS categories of thyroid nodules in the initial and control ultrasonography (US) of 350 patients with SAT have been evaluated in this retrospective observational study. Fine needle aspiration biopsy (FNAB) results and postsurgical data, if performed, have been estimated.

Results

A hundred patients (28.6%) with SAT had thyroid nodules at the time of the diagnosis, while 152 (43.4%) patients had a nodule in remission US (p < 0.001). The number of thyroid nodules was found to be higher in the control US as against the initial US (p = 0.001). EU-TIRADS scores of the nodules in the remission US were significantly higher than the scores at the time of the diagnosis (p < 0.001). FNAB was performed in 23% of nodules observed in the remission US, and the rate of thyroid carcinoma within them was 3.3%.

Conclusion

Thyroid nodules, malignancy suspected features, and EU-TIRADS categories of them may not be appropriately evaluated due to heterogenous paranchime of SAT. Performing a control US examination after resolution of hypoechoic areas may be beneficial to avoid missing clinically significant nodules with high EU-TIRADS scores.

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Author contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by S.H., H.B., P.A., M.E.S., M.K., O.O., and B.U.. The first draft of the manuscript was written by S.H. and all authors commented on previous versions of the manuscript. E.C. supervised the study. All authors read and approved the final manuscript.

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Authors and Affiliations

  1. University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey

    Sema Hepsen, Hayri Bostan, Pinar Akhanli, Muhammed Erkam Sencar, Muhammed Kizilgul, Bekir Ucan, Ozgur Ozcelik & Erman Cakal

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  1. Sema Hepsen
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  2. Hayri Bostan
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  3. Pinar Akhanli
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  4. Muhammed Erkam Sencar
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  5. Muhammed Kizilgul
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Correspondence to Sema Hepsen.

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This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital (Date: 28.06.2019/No:66/13).

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Informed consent was obtained from all individual participants included in the study.

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Hepsen, S., Bostan, H., Akhanli, P. et al. Subacute thyroiditis paranchime heterogeneity may mask thyroid nodules and higher EU-TIRADS scores. Endocrine 77, 291–296 (2022). https://doi.org/10.1007/s12020-022-03069-w

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  • DOI: https://doi.org/10.1007/s12020-022-03069-w

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