• Journal of the Korean Society of Radiology
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• v.15 no.4
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• pp.473-479
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• 2021

The diagnostic criteria for diffuse thyroid disease are ambiguous and there are many errors due to the subjective diagnosis of experts. Also, studies on ultrasound imaging of thyroid nodules have been actively conducted, but studies on diffuse thyroid disease are insufficient. In this study, features were extracted by applying the GLCM algorithm to ultrasound images of normal and diffuse thyroid disease, and quantitative analysis was performed using the extracted feature values. Using the GLCM algorithm for thyroid ultrasound images of patients diagnosed at W hospital, 199 normal cases, 132 mild cases, and 99 moderate cases, a region of interest (50×50 pixel) was set for a total of 430 images, and Autocorrelation, Sum of squares, sum average, sum variance, cluster prominence, and energy were analyzed using six parameters. As a result, in autocorrelation, sum of squares, sum average, and sum variance four parameters, Normal, Mild, and Moderate were distinguished with a high recognition rate of over 90%. This study is valuable as a criterion for classifying the severity of diffuse thyroid disease in ultrasound images using the GLCM algorithm. By applying these parameters, it is expected that errors due to visual reading can be reduced in the diagnosis of thyroid disease and can be utilized as a secondary means of diagnosing diffuse thyroid disease.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.26 no.7
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• pp.956-962
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• 2022

Diffuse thyroid disease has ambiguous diagnostic criteria and many errors occur according to the subjective diagnosis of skilled practitioners. If image processing technology is applied to ultrasound images, quantitative data is extracted, and applied to a computer auxiliary diagnostic system, more accurate and political diagnosis is possible. In this paper, 19 parameters were extracted by applying the Gray level co-occurrence matrix (GLCM) algorithm to ultrasound images classified as normal, mild, and moderate in patients with thyroid disease. Using these parameters, an artificial neural network (ANN) was applied to analyze diffuse thyroid ultrasound images. The final classification rate using ANN was 96.9%. Using the results of the study, it is expected that errors caused by visual reading in the diagnosis of thyroid diseases can be reduced and used as a secondary means of diagnosing diffuse thyroid diseases.

• Korean Journal of Head & Neck Oncology
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• v.14 no.1
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• pp.88-93
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• 1998

In order to review the clinicopathologic characteristics of the thyroid cancer associated with benign thyroid disease, we evaluated 47 patients treated between January, 1993 and September, 1997 at the Chonnam National University Hospital. In those period, we had operated a total of 690 thyroidectomy of which 320 were diagnosed as thyroid cancer. Forty three(91.4%)occurred in women and four(8.5%)occurred in men. The mean age at operation was 46.7years(range, 15 to 76 years). Forty three of the 47 cancers(91.4%) were papillary carcinomas while 4(8.5%)were follicular. Twenty four of the 47 patients (51%) were occult thyroid carcinomas measured less than 1 cm in diameter. The concurrent benign disease were nodular goiter(n=17), Hashimoto's thyroiditis(n=16), follicular adenoma(n=10), Graves' disease(n=2) and diffuse hyperplasia(n=2). Thirty one patients were diagnosed by preoperative FNAC and they underwent total thyroidectomy. Three were diagnosed by frozen section examination at the time of operation. Among them, one underwent total thyroidectomy and two underwent subtotal thyroidectomy. Eight cases revealed lymph node metastases and 2 cases extended to surrounding muscles. In conclusion, concurrent thyroid cancers and benign thyroid disease are not uncommon and a regular ultrasonic follow-up with selective aspiration cytologic examination is recommaned to enhance their diagnostic accuracy.

• International journal of thyroidology
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• v.10 no.1
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• pp.14-23
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• 2017

Background and Objectives: To evaluate and compare the diagnostic performances of grayscale ultrasound (US) and quantitative parameters obtained from texture analysis of grayscale US and elastography images in evaluating patients with diffuse thyroid disease (DTD). Materials and Methods: From September to December 2012, 113 patients (mean age, $43.4{\pm}10.7years$) who had undergone preoperative staging US and elastography were included in this study. Assessment of the thyroid parenchyma for the diagnosis of DTD was made if US features suggestive of DTD were present. Nine histogram parameters were obtained from the grayscale US and elastography images, from which 'grayscale index' and 'elastography index' were calculated. Diagnostic performances of grayscale US, texture analysis using grayscale US and elastography were calculated and compared. Results: Of the 113 patients, 85 (75.2%) patients were negative for DTD and 28 (24.8%) were positive for DTD on pathology. The presence of US features suggestive of DTD showed significantly higher rates of DTD on pathology, 60.7% to 8.2% (p<0.001). Specificity, accuracy, and positive predictive value was highest in US features, 91.8%, 84.1%, and 87.6%, respectively (all ps<0.05). Grayscale index showed higher sensitivity and negative predictive value (NPV) than US features. All diagnostic performances were higher for grayscale index than the elastography index. Area under the curve of US features was the highest, 0.762, but without significant differences to grayscale index or mean of elastography (all ps>0.05). Conclusion: Diagnostic performances were the highest for grayscale US features in diagnosis of DTD. Grayscale index may be used as a complementary tool to US features for improving sensitivity and NPV.

• The Korean Journal of Cytopathology
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• v.13 no.1
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• pp.33-37
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• 2002

We report two different types of thyroid lymphoma associated with Hashimoto's thyroiditis. Both showed autoantibodies and were compatible with Hashimoto's thyroiditis according to their clinical backgrounds. A 76-year-old female noted a painless, rapidly growing mass in her neck which was diagnosed as diffuse non-Hodgkin's lymphoma, large cell type, after the fine needle aspiration cytology of the thyroid. She underwent chemo-radiotherapy and is free of the disease 10 months after diagnosis. The other patient, a 73-year-old female with a diffuse golfer, was diagnosed on fine needle aspiration cytology as having Hashimoto's thyroiditis. Three years later she developed a hard nodular growth in the both lobes of the thyroid. This was subjected to fine needle aspiration cytology and needle biopsy and was diagnosed as a MALT lymphoma. She refused any treatment and died 12 months after the diagnosis.

• Korean Journal of Head & Neck Oncology
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• v.18 no.1
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• pp.60-64
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• 2002

Objectives: Three classic treatment modalities have been used to treat Graves' disease: antithyroid medication, radioiodine ablation, and subtotal thyroidectomy. Postoperative thyroid functions were studied in patients with Graves' disease treated by subtotal thyroidectomy to evaluate the superiority of surgical treatment. Materials and Methods: One hundred fourty patients of Graves' disease were analysed retrospectively in follow-up for more than three years following subtotal thyroidectomy. Postoperative serum levels of $T_3,\;T_4, TSH, TSH-R Ab, free $T_4$, were evaluated to watch hypo- or hyperthyroidsm. Results: In the evaluation of preop- and postoperative thyroid function after three years of subtotal thyroidectomy, $T_3$ was changed from $464.10{\pm}196.16ng/dl$ to $140.41{\pm}76.56ng/dl$ in mean value, $T_4$ was changed from $20.76{\pm}7.98{\mu}g/dl$ to $9.54{\pm}4.02{\mu}g/dl$, $TSHT_3$ was changed from $0.55{\pm}4.42{\mu}u/ml$ to $4.96{\pm}7.20{\mu}u/ml$, TSH-R Ab was changed from $41.6{\pm}28.27%$ to $28.7{\pm}28.79%$ and free $T_4$ was changed from $4.45{\pm}2.33ng/dl$ to $1.44{\pm}0.69ng/dl$ in mean value. Euthyroidism was noted in 118 patients(84.3%), overt hyperthyroidism in 6 patiens(4.3%), latent hyperthyroidism in 8 patients(5.7%), overt hypothyroidism in 2 patint(1.4%), and latent hypothyroidism in 6 patients(4.3%). Of surgical complications, permanant hypoparathyroidism was found in one patient, recurrent laryngeal nerve injury in two patients, postoprative bleeding with reoperation in two patients, and death in one patient. Conclusion: The thyroid function after subtotal thyroidectomy in diffuse toxic goiter is normal level (euthyroidism) in 84.3% and low recurrence rate of hyperthyroidism is showed with rare surgical complication. Therefore, subtotal thyroidectomy in diffuse toxic goiter is more effective and safe than RI or longterm ATD treatment, if the operation is performed by skillful surgeon.

• Childhood Kidney Diseases
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• v.25 no.1
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• pp.40-43
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• 2021

Enuresis is intermittent urinary incontinence during sleep at night in children aged 5 years or older. The main pathophysiology of enuresis involves nocturnal polyuria, abnormal sleep arousal, and low functional bladder capacity. In rare cases, enuresis is an early symptom of endocrine disorders such as diabetes or thyroid disorders. Herein, we report a case of a 12-year-old girl with enuresis as a rare initial presentation of Graves' disease. She complained of nocturnal enuresis from a month before visiting our clinic. She also complained of urinary frequency, headache, and weight loss. On physical examination, she had tachycardia, intention tremors, and a diffuse goiter on her anterior neck with bruit on auscultation. Her thyroid function test results revealed hyperthyroidism, and Graves' disease was diagnosed as the thyroid stimulating hormone receptor autoantibody was positive. After treatment for Graves' disease with methimazole, symptoms of enuresis resolved within 2 weeks as she became clinically and biochemically euthyroid. In children with secondary enuresis, Graves' disease should be considered as a differential diagnosis, and signs of hyperthyroidism should be checked for carefully.

• Korean Journal of Head & Neck Oncology
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• v.9 no.1
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• pp.16-24
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• 1993

During 7 years, from Jan. 1986 to Dec. 1992, authors studied 208 cases of the surgically managed thyroid nodules at the Department of General Surgery, Han Kang Sacred Heart Hospital and obtained the following results. 1) Among the total 208 cases, male to female ratio was 1:11.2 in benign thyroid diseases and 1:9 in malignant thyroid diseases. The benign disease was prevalent between second and forth decade comparing with malignant disease between third and fifth decade. 2) The most common duration of illness was 3 months(26.0%). 3) Palpable neck mass was the most common chief complaint(100%). Palpitation. fatigue, and sweating were common complaints in patient with benign disease, and fatigue, palpitation, and sweating in malignant disease in decreasing order of frequency. 4) 55.8 % of lesions were in right lobe, 33.2% in left lobe, 5.8% in diffuse type, 4.8% in bilateral lobes, and 0.5% in isthmus. 5) The most common size of nodule was between 2.0cm and 3.9cm in diameter, which consisted of 55.1% of benign disease and 48.0% of malignant disease. 6) 86.5% of thyroid function test showed euthyroidism, 10.1% hyperthyroidism, and 3.4% hypothyroidism. 7) Thyroid scanning of 176 patients revealed cold nodules in 92.5% of benign diseases and in 92.9% of malignant diseases. 8) The most common benign disease was adenomatous hyperplasia(62.7%), and the most common malignant disease was papillary adenocarcinoma(80.0%). 9) Fine needle aspiration cytology was performed in 91 cases, and it showed 69.0% of sensitivity, 90.3% of specificity, and 83.5% of accuracy. 10) Frozen biopsy was performed in 109 cases. and it showed 93.9% of sensitivity, 100.0% of specificity, and 98.2% of accuracy. 11) The most commonly performed operation was unilateral lobectomy(including unilateral lobectomy with isthmectomy)(79.1%) in benign disease. and total thyroidectomy(62.0%) in malignant disease. 12) Postoperative complication showed 5 cases of wound infection (2.4%), 3 cases of transient hypoparathyroidism(1.4%), 3 cases of transient hoarseness(1.4%), 2 cases of postoperative bleeding(1.0%), 1 case of permanent hypoparathyroidism(0.5%), 1 case of permanent hoarseness(0.5%), and 1 case of postoperative pneumonia (0.5%).

• Nuclear Medicine and Molecular Imaging
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• v.43 no.2
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• pp.154-155
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• 2009

A 45-year-old man presented with fatigue and weight loss underwent a Tc-99m MDP bone scan because of increased serum alkaline phosphatase. Delayed images at 4 hours demonstrated diffuse increased activity throughout both lobes of the thyroid in the absence of activity of the stomach and salivary glands. Thyroid laboratory indices and a Tc-99m pertechnetate thyroid scan suggested Graves' hyperthyroidism.

• The Korean Journal of Nuclear Medicine
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• v.3 no.2
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• pp.33-38
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• 1969

The serum thyroxine levels were measured by method of Tetrasorb Kit in 69 subjects including 13 subjects in euthyroid state, 31 with hyperthyroidism, 5 with hypothyroidism, 13 with nontoxic diffuse goiter, and 7 with nontoxic nodular goiter. Three parameters of the thyroid function test including thyroxine ($T_4$) levels, $^{131}I$ uptake (24 hrs) values and $PB^{131}I$ conversion ratio were correlated with clinical manifestations and courses of the disease. 1. The serum $T_4$ levels in the normal subjects were in range of $6.0{\mu}g/dl\;to\;14.4{\mu}g/dl$. (The mean $9.4{\mu}g/dl$). 2. The diagnostic compatibility of the serum $T_4$ was 93.5% in hyperthyroidism, 100% both in hypothyroidism and in nontoxic diffuse goiter, 86% in nontoxic nodular goiter, or 95.8% in the entire series. (Table 1). 3. The diagnostic compatibility of $^{131}I$ uptake (24 hrs) values and $PB^{131}I$ conversion ratio were less than the serum $T_4$ levels as summarized in Tables 2 & 3. The serum $T_4$ determination by Tetrasorb Kit is a simple, accurate and very useful test of the thyroid function.