BACKGROUND: Thyrotoxic atrial fibrillation (TAF) is associated with an increase in total and cardiovascular mortality, mainly due to the thromboembolic events. Therefore, thromboembolism prevention is an important TAF treatment component. Thus, it seems interesting to identify TAF thromboembolic complications predictors.

TAF is a potentially reversible state. However, the spontaneous reversion to sinus rhythm after the euthyroidism achievement does not occur in all patients. In patients with a history of thyrotoxicosis the hospitalization rate due to cardiovascular pathology, and due to atrial fibrillation (AF), in particular, is higher than in the general population, even after the radical treatment of thyrotoxicosis.

The development of prediction tools for mentioned above TAF complications and adverse outcomes, would make it possible to create more detailed and high-quality guidelines for the management of patients with thyrotoxicosis-induced AF. At the same time, the predictors of TAF thromboembolic complications and TAF maintenance after the euthyroid state is achieved, are not well currently understood.

AIM: The purpose of this study was to identify risk factors for TAF adverse outcomes: thromboembolic events and the lack of spontaneous reversion to sinus rhythm after the euthyroidism was achieved.

MATERIALS AND METHODS: This is a retrospective study of 70 patients aged 24 to 70 years with a history of overt thyrotoxicosis and TAF. The following parameters were analyzed in all participants: thromboembolic events due to TAF, the presence of the spontaneous reversion to sinus rhythm after the euthyroidism was achieved and potentially associated with TAF adverse outcomes factors: a number of clinical and demographic factors, echocardiography data and characteristics of the TAF course. Regression analysis was performed to study the effect of these potential predictors on the risk of the thromboembolism and TAF maintenance. The cut-off points for the identified risk factors were determined by receiver operating characteristic (ROC) curves creating.

RESULTS: The analysis showed that the only independent TAF thromboembolic complications predictor among studied parameters was the large left atrium diameter (>4.3 cm), and the predictors of TAF maintenance after the euthyroid state is achieved included the large left ventricle end-diastolic size (>4.5 cm) and the presence of left atrium dilation.

CONCLUSION: In this study, echocardiographic parameters associated with TAF thromboembolic complications and TAF persistence after euthyroid state is achieved, were identified. This may be useful for the TAF adverse outcomes risk assessment tools development in the future.

The article describes a method for assessing the malignancy potential of thyroid nodules and their stratification according to the European Thyroid Imaging And Reporting Data System (Eu-TIRADS) scale based on ultrasound diagnostic images using an artificial intelligence system. The method is based on the use of transfer learning technology for multi-parameter models of convolutional neural networks and their subsequent fine tuning. It was shown that even on a small dataset consisting of 1129 thyroid ultrasound images classified by 5 Eu-TIRADS categories, the application of the method provides high training accuracy (Accuracy: 0.8, AUC: 0.92). This makes it possible to introduce and use this technology in clinical practice as an additional tool (‘second opinion’) for an objective assessment of the risk of malignancy in thyroid nodules for the purpose of their further selection for fine needle biopsy.

INTRODUCTION. Typical clinical features of subacute thyroiditis (SAT) are commonly assessed such as – neck pain and high body temperature, as well as thyroid function abnormalities, elevated inflammatory markers, and strongly suggestive hypoechoic ultrasonography characteristics. Non-steroid anti-inflammatory agents and corticosteroids are used.

AIM. To examine the clinical characteristics in patients with SAT, by determining the level of thyroid hormones, the size and structure of the thyroid gland as well as ultrasound and scintigraphy findings.

MATERIALS AND METHODS. We performed retrospective analysis in 122 cases of SAT (both genders, mean age 45.05±12,18 years), in the period 2015-2020. We evaluated monthly frequency of the SAT occurrence, the clinical status of the patients including symptoms, body temperature, laboratory results of FT4 and TSH, CRP and ESR level, ultrasonography and scintigraphy findings.

RESULTS. Most of the patients complained of neck pain, high body temperature was detected in 66/100 (66%) pts. CRP and ESR Patients were usually diagnosed in hyperthyroid phase of the disease. Enlarged thyroid gland was mostly seen on US, while 52 had normal thyroid gland, with predominantly hypoechoic non-chomogenous structure. Scintigraphy noted “empty” scan (without presentation of functional thyroid tissue) in 72/98 (73,47%) and hypofixation mainly in both lobes in 26/98 (26,53%) pts.

CONCLUSION. The awareness of physicians needs to be increased in patients with neck pain for proper diagnosis of SAT, that is often is often misdiagnosed or delayed, leading to erroneous antibiotic overuse. Generally, nonsteroidal anti-inflammatory drugs are effective in reducing thyroid pain in patients with mild cases.

Advances in the development and improvement of medical technologies and methods of processing medical images make it possible to highlight clinically significant characteristics that were not previously available to classical methods of medical imaging. Ultrasound diagnostics of thyroid gland nodules has a huge potential medical images processing. The article presents an overview of the existing ultrasound classification systems for thyroid nodules malignancy and the prospects for the development of intellectual tools TIRADS (Thyroid Imaging Reporting and Data System) classification system.