eMedicine Specialties > Radiology > Head/Neck

Thyrotoxicosis: Multimedia

Author: John L Floyd, MD, FACR, FRCR, Director of Nuclear Medicine Services, Department of Nuclear Radiology, St Luke's Methodist Hospital and Mercy Medical Center; Consulting Staff, Radiology Consultants of Iowa
Contributor Information and Disclosures

Updated: Oct 13, 2009

Multimedia

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Media file 1: Illustration of the negative feedback loop of the homeostasis of thyroid hormone levels. A decrease in blood thyroid hormone triiodothyronine (T3)/thyroxine (T4) levels results in the inhibition of thyrotropin-releasing hormone and thyrotropin production. The released thyrotropin stimulates synthesis and release of T3/T4 by the thyroid, which, in turn, tends to inhibit further thyrotropin release. THS is thyrotropin. TRH is thyrotropin-releasing hormone.

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Illustration of the negative feedback loop of the homeostasis of thyroid hormone levels. A decrease in blood thyroid hormone triiodothyronine (T3)/thyroxine (T4) levels results in the inhibition of thyrotropin-releasing hormone and thyrotropin production. The released thyrotropin stimulates synthesis and release of T3/T4 by the thyroid, which, in turn, tends to inhibit further thyrotropin release. THS is thyrotropin. TRH is thyrotropin-releasing hormone.

(Enlarge Image)

Media file 2: Iodine-123 thyroid scan in a patient with Graves disease: Tracer uptake is uniform throughout the gland. The 5-hour iodine uptake was high at 53%.

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Iodine-123 thyroid scan in a patient with Graves disease: Tracer uptake is uniform throughout the gland. The 5-hour iodine uptake was high at 53%.

(Enlarge Image)

Media file 3: Iodine-123 thyroid scan in a patient with Graves disease. The 5-hour iodine uptake was elevated at 29%. Note the high level of iodine concentration near the thyroid. Also note the pyramidal lobe, which often is visualized in a hyperstimulated gland. The cold nodule in the right lobe must be addressed in the same way a solitary cold nodule in a patient without Graves disease is evaluated.

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Iodine-123 thyroid scan in a patient with Graves disease. The 5-hour iodine uptake was elevated at 29%. Note the high level of iodine concentration near the thyroid. Also note the pyramidal lobe, which often is visualized in a hyperstimulated gland. The cold nodule in the right lobe must be addressed in the same way a solitary cold nodule in a patient without Graves disease is evaluated.

(Enlarge Image)

Media file 4: Ultrasonogram of the right lobe of the thyroid in the same patient as in Image above. Fine-needle aspiration of the nodule prior to iodine-131 treatment did not reveal a carcinoma.

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Ultrasonogram of the right lobe of the thyroid in the same patient as in Image above. Fine-needle aspiration of the nodule prior to iodine-131 treatment did not reveal a carcinoma.

(Enlarge Image)

Media file 5: Iodine-123 scan in a patient with a palpable nodule in the right neck, a low serum level for thyrotropin, and a slightly elevated serum level of free triiodothyronine. The autonomously functioning nodule only partially suppresses uptake in the remainder of the gland. The 5-hour iodine uptake was mildly elevated at 22%.

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Iodine-123 scan in a patient with a palpable nodule in the right neck, a low serum level for thyrotropin, and a slightly elevated serum level of free triiodothyronine. The autonomously functioning nodule only partially suppresses uptake in the remainder of the gland. The 5-hour iodine uptake was mildly elevated at 22%.

(Enlarge Image)

Media file 6: Scan in a patient with a toxic multinodular goiter: The 5-hour iodine uptake was elevated at 28%. Note the multiple foci of variably increased tracer uptake.

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Scan in a patient with a toxic multinodular goiter: The 5-hour iodine uptake was elevated at 28%. Note the multiple foci of variably increased tracer uptake.

(Enlarge Image)

Media file 7: Color flow ultrasonogram in the same patient as in Image 2 in Multimedia. Generalized hypervascularity is visible throughout the gland, which often can be heard as a hum or bruit with a stethoscope.

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Color flow ultrasonogram in the same patient as in Image 2 in Multimedia. Generalized hypervascularity is visible throughout the gland, which often can be heard as a hum or bruit with a stethoscope.

More on Thyrotoxicosis

Overview: Thyrotoxicosis

Imaging: Thyrotoxicosis

Follow-up: Thyrotoxicosis

Multimedia: Thyrotoxicosis

References

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Keywords

thyrotoxicosis, Graves disease, Grave's disease, toxic nodule, toxic multinodular goiter, TMNG, thyroiditis, free thyroxine, T4, triiodothyronine, T3, hyperthyroidism

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Contributor Information and Disclosures

Author

John L Floyd, MD, FACR, FRCR, Director of Nuclear Medicine Services, Department of Nuclear Radiology, St Luke's Methodist Hospital and Mercy Medical Center; Consulting Staff, Radiology Consultants of Iowa
John L Floyd, MD, FACR, FRCR is a member of the following medical societies: American College of Radiology, Radiological Society of North America, and Society of Nuclear Medicine
Disclosure: Nothing to disclose.

Medical Editor

Hussein M Abdel-Dayem, MD, Chief, Nuclear Medicine Service, Department of Radiology, Professor of Radiology, St Vincent's Catholic Medical Centers of New York
Disclosure: none None None

Pharmacy Editor

Bernard D Coombs, MB, ChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand
Disclosure: Nothing to disclose.

Managing Editor

C Douglas Phillips, MD, Director of Head and Neck Imaging, Division of Neuroradiology, Weill Medical College of Cornell University/New York Presbyterian Hospital
C Douglas Phillips, MD is a member of the following medical societies: American College of Radiology, American Medical Association, American Society of Head and Neck Radiology, American Society of Neuroradiology, Association of University Radiologists, and Radiological Society of North America
Disclosure: Nothing to disclose.

CME Editor

Robert M Krasny, MD, Resolution Imaging Medical Corporation
Robert M Krasny, MD is a member of the following medical societies: American Roentgen Ray Society and Radiological Society of North America
Disclosure: Nothing to disclose.

Chief Editor

Eugene C Lin, MD, Consulting Radiologist, Virginia Mason Medical Center; Clinical Assistant Professor of Radiology, University of Washington School of Medicine
Eugene C Lin, MD is a member of the following medical societies: American College of Nuclear Medicine, American College of Radiology, Radiological Society of North America, and Society of Nuclear Medicine
Disclosure: Nothing to disclose.

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eMedicine Specialties > Radiology > Head/Neck

Thyrotoxicosis: Multimedia

Multimedia

Iodine-123 thyroid scan in a patient with Graves disease: Tracer uptake is uniform throughout the gland. The 5-hour iodine uptake was high at 53%.

Ultrasonogram of the right lobe of the thyroid in the same patient as in Image above. Fine-needle aspiration of the nodule prior to iodine-131 treatment did not reveal a carcinoma.

Scan in a patient with a toxic multinodular goiter: The 5-hour iodine uptake was elevated at 28%. Note the multiple foci of variably increased tracer uptake.

Color flow ultrasonogram in the same patient as in Image 2 in Multimedia. Generalized hypervascularity is visible throughout the gland, which often can be heard as a hum or bruit with a stethoscope.

More on Thyrotoxicosis

References

Further Reading

Keywords

Contributor Information and Disclosures

Author

Medical Editor

Pharmacy Editor

Managing Editor

CME Editor

Chief Editor