Endocrine Abstracts

Objective : To determine whether simultaneous ultrasonography at the time of scintigraphy affects the diagnosis or diagnostic confidence in patients with hyperthyroidism.
Method Used: A retrospective study was carried out involving 100 patients who attended for investigation of hyperthyroidism between 01/07/01 and 31/03/02. All patients ( 15 male, 85 female) had simultaneous radioisotope scanning and ultrasound of their thyroid glands performed and reported. Subsequently the radio-isotope images were reported on in isolation and a second report generated. The results of the two reports were compared.
Results: It was found that the reports were the same in 88 cases, different in 12 cases (the diagnosis changing from isolated scintigraphy to combined examination in (n) cases as follows: MNG (multinodular goitre) to Graves (3), Graves to normal in (3), thyroiditis to MNG (2), STA (solitary toxic adenoma) to MNG (1), MNG to normal (1), Graves to MNG (1) and MNG to STA (1) ).
A significant cold nodule was out-ruled in 27 cases (23 in MNG, 3 in Graves and 1 in STA).
The confidence of making a certain diagnosis was increased in 21 cases , these cases being , 9 Graves, 9 MNG, 2 STA and 1 case of thyroiditis.
Conclusions: This study demonstrates that in hyperthyroid patients simultaneous ultrasound and radio-isotope scanning leads to change in diagnosis in 12 percent of patients and increased confidence in 21 percent of patients, when compared with radio-isotope scanning alone. A significant cold nodule was out-ruled in 27 percent of cases. We would recommend simultaneous ultrasound is adopted as standard practise in patients undergoing scintigraphy for hyperthyroidism.