SFEBES2023 Oral Poster Presentations Thyroid (4 abstracts)
Incidental thyroid nodules on CT Angiography in patients presenting with acute stroke: incidence and clinical outcomes from a regional stroke centre
Christine o Connor 1 , Ivan Wiggam 1 , Peter Ellis 2 , Titus Cvascuic 3 , Alyson Harfield 1 , Sarine Dooht 1 , Ammar Ahmed 1 , Jordan McKenna 1 , Jessica Lynsey 1 , Shyrea Sengupta 1 , Patricia Gordon 1 , Louise Alexander 1 , Enda Kerr 1 , Patricia Fearon 1 , Cathy Patterson 1 , Gerallt Roberts 1 , Jim Mc Ilmoyle 1 & Philip C Johnston 4
1Department of Stroke Medicine, Royal Victoria Hospital, Belfast, Belfast, United Kingdom. 2Department of Radiology, Royal Victoria Hospital, Belfast, United Kingdom. 3Department of Endocrine Surgery, Royal Victoria Hospital, Belfast, Belfast, United Kingdom. 4Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast, N Ireland, UK, Belfast, United Kingdom
Background: CT Angiography (CTA) is a frequently used modality of imaging for assessment and diagnosis of patients presenting with acute stroke. There is a paucity of data on management guidelines for the presence of incidental thyroid nodules found on CT Angiography in patients presenting with acute stroke.
Methods: A retrospective analysis was conducted on 2092 patients presenting with acute stroke, identified through the Sentinel Stroke National Audit Programme (SSNAP) audit from January 2019 through to December 2021.
Results: From the cohort, 1046 patients admitted with acute stroke subsequently had a CTA performed. Of these, 79 patients had incidental thyroid nodules noted, corresponding to a prevalence of 7.5%. Around half of these patients, 37 underwent formal thyroid ultrasonography (US). Thyroid nodule size ranged from 2mm to 8 cm, 18/79 (22%) were bilateral. Further US results revealed that one patient (2.7%) had no discernible nodules, twenty two (59.5%) labelled as U2, 12 (32.4%) as U3, two (5.4%) as U4 and none as U5. For the remaining 42 patients not receiving US, 28 patients had no reason documented for not perusing further investigations, 8 patients were deceased in the short period following acute stroke. Five (6.3%) patients had thyroid surgery, based on subsequent FNA cytology: 1 had follicular variant of papillary thyroid carcinoma, 2 with follicular thyroid carcinoma, 1 papillary thyroid carcinoma, 1 benign histology.
Conclusions: In this study, incidental thyroid nodules were identified in 7.5 % of post-stroke patients undergoing CTA. The risk of malignancy was small at 6%. The presence of incidentally noted thyroid nodules on CTA in the work up of stroke has to be balanced in the context of an acutely unwell patient and the appropriateness of further investigations. We are establishing a pathway locally to guide stroke physicians as to guide onward appropriate referral to specialist care.
Volume 94
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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