Graves' disease treated with thyroid arterial embolization.
OBJECTIVE
To study pathological changes in the thyroid gland of patients with Graves' disease (GD) treated with thyroid arterial embolization.


METHODS
Thirty-seven patients with GD were treated through transcatheter thyroid arterial embolization. Of these patients, twenty-two had biopsy of the thyroid gland at different time points before and after the embolization for the study of pathology. Serum thyroid hormones, TSH and TRAb were also studied at these time points. Thyroid size was evaluated in all patients using color Doppler ultrasound or CT scan.


RESULTS
Thyroid size decreased immediately or several days following embolization. Pathological study demonstrated mainly acute infarction and necrosis at 7 days post embolization. At 6 months, chronic inflammation and fibrous hyperplasia were the primary findings in the gland, and at 3 years following embolization, mesenchyma hyperplasia and follicle atrophy were primarily present in the embolized thyroid tissue. The thyroid hormones and TSH gradually resumed to normal range after embolization while TRAb decreased significantly.


CONCLUSIONS
Thyroid arterial embolization can cause GD thyroid gland a series of pathological changes of acute ischemia and necrosis and later, chronic inflammation, fibroplasia and atrophy to decrease secretion of thyroid. The pathological changes within the thyroid gland after embolization form the basis of thyroid arterial embolization in treating GD hyperthyroidism.
Zhao
Wei
W
Medical Imaging Center, First Affiliated Hospital, Kunming Medical College, Yunnan Province, China.
Gao
Bu-Lang
BL
Tian
Min
M
Yi
Gen-Fa
GF
Yang
Hui-Ying
HY
Shen
Li-Juan
LJ
Li
Hong
H
Shen
Jin
J