Doppler evaluation of intrathyroid arterial resistances during preoperative treatment with Lugol’s iodide solution in patients with diffuse toxic goiter

• Published in: Journal of the American College of Surgeons Vol. 191; no. 6; pp. 607 - 612
• Main Authors: Ansaldo, Gian Luca, Pretolesi, Fabio, Varaldo, Emanuela, Meola, Cristiano, Minuto, Michele, Borgonovo, Giacomo, Derchi, Lorenzo E, Torre, Gian Carlo
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.12.2000; Elsevier Science; American College of Surgeons
• Subjects: Adult; Antithyroid Agents - therapeutic use; Arteries - drug effects; Arteries - physiopathology; Biological and medical sciences; Blood Loss, Surgical - prevention & control; Case-Control Studies; Combined Modality Therapy; Drug Monitoring - methods; Endocrine glands; Endocrinopathies; Female; Graves Disease - blood; Graves Disease - diagnostic imaging; Graves Disease - physiopathology; Graves Disease - therapy; Hemostatics - therapeutic use; Humans; Investigative techniques, diagnostic techniques (general aspects); Iodides - therapeutic use; Male; Medical sciences; Methimazole - therapeutic use; Middle Aged; Non tumoral diseases. Target tissue resistance. Benign neoplasms; Preoperative Care - methods; Thyroid Function Tests; Thyroid Gland - blood supply; Thyroid. Thyroid axis (diseases); Thyroidectomy - adverse effects; Ultrasonic investigative techniques; Ultrasonography, Doppler - methods; Ultrasonography, Doppler - standards; Vascular Resistance - drug effects; Endocrinopathy; Sonography; Doppler ultrasound study; Human; Thyroid diseases; Exploration; Thyroid gland; Thyroidectomy; Vascularization; Resistance; Efficiency; Goiter; Surgery; Preoperative
• ISSN: 1072-7515; 1879-1190
• DOI: 10.1016/S1072-7515(00)00755-9

Background: The aim of this study was to ascertain the utility of echo-Doppler in the analysis of the low resistance thyroid vascularization in diffuse toxic goiter (DTG), and the effectiveness of Lugol’s solution (iodine-iodide solution) in patients undergoing thyroidectomy. Study Design: Twenty-five patients with diffuse toxic goiter were evaluated and compared with 19 normal subjects. Patients were treated with increasing doses of Lugol’s solution 2% for 7 days until a total dose of 75 mg of iodine was given. Echo-Doppler was performed on the last day of treatment, 12 hours before operation. Results: Mean basal Doppler Resistance Index (RI) of intrathyroid arterial flow was significantly lower in patients with DTG compared with normal controls (0.4718 ± 0.0625 versus 0.55 ± 0.05, range: 0.472 to 0.643; p = 0.008). Moreover, the RI was significantly increased in patients with DTG after Lugol’s solution (+16.46 ± 10.22%, range: −2.59 to +39.97; p < 0.0005). Conclusions: Echo-Doppler RI allowed documenting lower arterial resistances within the thyroid gland in patients with DTG. The use of preoperative Lugol’s solution therapy induces normalization of those changes for safer thyroidectomy.