Document Detail


Use of 3-dimensional sonography for prenatal evaluation and follow-up of fetal goitrous hypothyroidism.
MedLine Citation:
PMID:  20733190     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Fetal goitrous hypothyroidism is a rare and potentially lethal condition. Consequently, its early diagnosis and treatment improve prognosis. Thyroid hormone measurement in either fetal serum or amniotic fluid implies important risks. Here we present a fetal goiter and the follow-up procedure, both done by the traditional method and by using 3-dimensional power Doppler (3DPD) imaging and virtual organ computer-aided analysis (VOCAL).
METHODS: A single well-documented case of fetal goiter was followed weekly from 22 weeks until delivery. Amniocentesis for thyrotropin (TSH) and free thyroxine (T(4)) measurement as well as levothyroxine injections were performed at every control. In addition to amniocentesis, every control involved a sonographic evaluation, which included standard measurements of the gland and the capture of volume image sets in gray scale and 3DPD. Volume calculation of the gland was done using VOCAL software. Vascularization of the gland was evaluated by the vascularization index (VI) included in the software.
RESULTS: With treatment, TSH levels decreased progressively until normalization. Free T(4) levels increased toward the end of gestation. Sonographic measurements of the gland volume to estimated fetal weight ratio decreased across treatment as levels of TSH did. The VI clearly depicted the vascular regression of the goiter, decreasing throughout treatment in a consistent way until 24 hours before delivery.
CONCLUSIONS: Gray scale and 3DPD evaluations of the thyroid gland have been validated under similar circumstances and might be reliable complements to the invasive methods used in the management of this fetal condition.
Authors:
Rodrigo Cuevas Marín; Juan Carlos Bello-Muñoz; Gabriel Villagómez Martínez; Silvia Arévalo Martínez; Elena Carreras Moratonas; Lluis Cabero Roura
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine     Volume:  29     ISSN:  1550-9613     ISO Abbreviation:  J Ultrasound Med     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-24     Completed Date:  2011-01-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8211547     Medline TA:  J Ultrasound Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1339-43     Citation Subset:  IM    
Affiliation:
Fetal Medicine Unit, Vall d'Hebron University Hospital, Universidad Autónoma de Barcelona, Barcelona, Catalunya, Spain.
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MeSH Terms
Descriptor/Qualifier:
Adult
Amniocentesis
Biological Markers / analysis
Diagnosis, Differential
Female
Fetal Diseases / ultrasonography*
Goiter / ultrasonography*
Humans
Hypothyroidism / ultrasonography*
Imaging, Three-Dimensional*
Pregnancy
Thyroid Function Tests
Ultrasonography, Prenatal / methods*
Chemical
Reg. No./Substance:
0/Biological Markers

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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