Advertisement

Journal of Endocrinological Investigation

, Volume 4, Issue 3, pp 335–341 | Cite as

Thyroid blood flow rate in man. Electromagnetic flowmetry during operation in euthyroid normal gland, nontoxic goiter, and hyperthyroidism

  • Lennart Tegler
  • J. Gillquist
  • B. Anderberg
  • B. Lundström
  • H. Johansson
Article

Abstract

Human thyroid blood flow rate (TBF) was measured during operations by electromagnetic flowmetry in 75 euthyroid patients with normal thyroid tissue, nodular goiter, or solitary adenoma, and in 22 hyperthyroid patients with diffuse or nodular goiter. Blood flow rate was measured in one to four of the thyroid arteries. No difference in blood flow rate was seen between the left and right lobes. The slight difference found between the inferior and superior arteries was not significant. I n each subject, total TBF was calculated as 4 times the mean of the recorded blood flow in the single arteries. The total TBF was 31 (9–109) ml/min (inner 95 percentile range) in euthyroid patients, similar in all 3 groups. This is less than in most earlier reports. The relativeTBF was 1.2 (0.4–3.8) ml/min/g thyroid tissue in normal thyroid tissue and 0.6 (0.1–3.7) ml/min/g in nontoxic nodular goiter (p<0.001). Patients with hyperthyroidism had a higher total TBF 54 (15–197) ml/min (p<0.001), despite preoperative treatment giving euthyroidism. Similar TBF rates were found in 3 hyperthyroid patients given propranolol preoperatively. Electromagnetic flowmetry is applicable to study thyroid blood flow rate. Human TBF shows considerable interindividual variations, which must be kept in mind when studying directly the rate of thyroid hormone secretion from arteriovenous gradients.

Key-words

Blood flow normal thyroid gland nontoxic goiter hyperthyroidism human electromagnetic flowmetry intraoperative 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Chopra I.J. Nature, source and biologic significance of thyroid hormones in blood. In: Werner S.C., Ingbar S.H. (Eds.), The thyroid, ed. 4. Haper and Row, Hagerstown, 1978, p. 100.Google Scholar
  2. 2.
    Di Stefano III J.J., Fisher D.A. Peripheral distribution and metabolism of the thyroid hormones: a primarily quantitative assessment. In: Hershman J.M., Bray G.A. (Eds.), The thyroid. Pergamon Press, Oxford, 1979, p. 47.Google Scholar
  3. 3.
    Mowbray J.F., Peart W.S. Effects of noradrenaline and adrenaline on the thyroid. J. Physiol. (London) 151: 261, 1960.Google Scholar
  4. 4.
    Falconer I.R. The effect of adrenaline and noradrenaline on hormone secretion and blood flow from the thyroid vein in sheep with exteriorized thyroids. J. Physiol. (London) 188: 425, 1967.Google Scholar
  5. 5.
    Westgren U., Melander A., Ingemansson S., Burger A., Tibblin S., Wåhlin E. Secretion of thyroxine, 3,5,3’-triiodothyronine and 3,3’,5-triiodo- thyronine in euthyroid man. Acta Endocrinol. (Kbh.) 84: 281, 1977.Google Scholar
  6. 6.
    Hooper M.J., Ratcliffe J.G., Ratcliffe W.A., Marshall J., Young R.E., Ngaei G., Clark D.H. Evidence for thyroidal secretion of 3,3’,5’-triiodothyro-nine in man and its control by TSH. Clin. Endocrinol. (Oxf.) 8: 267, 1978.CrossRefGoogle Scholar
  7. 7.
    Tegler L., Almqvist S., Baldor F., Gillquist J., Johansson H., Lundström B. Secretion rates of triiodothyronine (T3) and thyroxine (T4) from the human thyroid gland: Peroperative study in the normal gland and in atoxic goiter. In: Robbins J., Braverman L.E. (Eds.), Thyroid research. Excerpta Medica, Amsterdam, 1976, p. 221.Google Scholar
  8. 8.
    Cappelen Jr C., Hall K.V. Intra-operative blood flow measurements with electromagnetic flowmeter. Prog. Surg. 8:102, 1970.PubMedGoogle Scholar
  9. 9.
    Mitsuma T., Colucci J., Shenkman L., Hollander C.S. Rapid simultaneous radioimmunoassay for triiodothyronine and thyroxine in unextracted serum. Biochem. Biophys. Res. Commun. 46:2107, 1972.PubMedCrossRefGoogle Scholar
  10. 10.
    Ekins R.P., Ellis S.M. The radioimmunoassay of free thyroid hormones in serum. In: Robbins J., Braverman L.E. (Eds.), Thyroid research. Excerpta Medica, Amsterdam, 1976, p. 597.Google Scholar
  11. 11.
    Odell W.D., Wilber J.F., Paul W.E. Radioimmunoassay of thyrotropin in human serum. J. Clin. Endocrinol. Metab. 25:1179, 1965.PubMedCrossRefGoogle Scholar
  12. 12.
    Bergfelt G., Ljunggren J.G., Hedberg K. Preoperative treatment of thyrotoxicosis with antithyroid drugs and thyroxine. J. Clin. Endocrinol. Metab. 21:72, 1961.CrossRefGoogle Scholar
  13. 13.
    Anderberg B., Kågedal B., Nilsson O.R., Smeds S., Tegler L., Gillquist J. Propranolol and thyroid resection for hyperthyroidism. Acta Chir. Scand. 145: 297, 1979.PubMedGoogle Scholar
  14. 14.
    Gillquist J., Lundström B., Larsson L., Sjödahl R., Bröte L., Anderberg B. Peroperative estimation of the size of the thyroid remnant. Acta Chir. Scand. 145: 459, 1979.PubMedGoogle Scholar
  15. 15.
    Hedenstierna G., Löfström J.B. Cardiac output and venous admixture during intermittent positive pressure breathing. Br. J. Anaesth. 45:1201, 1973.PubMedCrossRefGoogle Scholar
  16. 16.
    Meisner H., Messmer K. Significance and limitations of electromagnetic blood flowmetry. Prog. Surg. 8:124, 1970.PubMedGoogle Scholar
  17. 17.
    Almgård L.E., Böök K., Delin N.A. Renal blood flow measured simultaneously with electromagnetic flowmeter and paraaminohippurate clearance in the dog. In: Cappelen Jr C. (Ed.), Newfindings in blood flowmetry. Universitetsforlaget, Oslo, 1968, p. 168.Google Scholar
  18. 18.
    Tetirick J.E., Mengoli L. Calibration and use of square-wave electromagnetic flowmeter. Surgery 54:621, 1963.PubMedGoogle Scholar
  19. 19.
    Armitage P. Statistical methods in medical research. Blackwell Scientific Publications, Oxford, 1971.Google Scholar
  20. 20.
    Söderberg U. Temporal characteristics of thyroid activity. Physiol. Rev. 39: 777, 1959.PubMedGoogle Scholar
  21. 21.
    Ahn C.S., Athans J.C., Rosenberg I.N. Effects of epinephrine and of alteration in glandular blood flow upon thyroid function: studies using thyroid cannulation in dogs. Endocrinology 84: 501, 1969.PubMedCrossRefGoogle Scholar
  22. 22.
    Varga B., Stark E., Marton J., Csáki L. The effect of TSH on thyroid blood flow in the dog. Endocrinol. Exp. (Bratisl.) 5: 211, 1971.Google Scholar
  23. 23.
    Canon J.A. The clinical application of the electromagnetic blood flowmeter in direct arterial surgery. In: Cappelen Jr C. (Ed.), Newfindings in blood flowmetry. Universitetsforlaget, Oslo, 1968, p, 198.Google Scholar
  24. 24.
    Samnegård H., Thulin L. Electromagnetic blood flowmetry. Opusc. Med. 24:71, 1979.Google Scholar
  25. 25.
    Moran J.M. Blood flowmeters. N. Engl. J. Med. 276: 225, 1967.PubMedCrossRefGoogle Scholar
  26. 26.
    Roberts V.C. Haematocrit variations and electromagnetic flowmeter sensitivity. Biomed. Engin. 4: 408, 1969.Google Scholar
  27. 27.
    Brownlie B.E.W., Turner J.G., Ellwood M.A., Rogers T.G.H., Armstrong D.I. Thyroid vascularity — documentation of the iodide effect in thyrotoxicosis. Acta Endocrinol. (Kbh.) 86: 317, 1977.Google Scholar
  28. 28.
    Brownlie B.E.W., Rogers T.G.H., Turner J.G. Thyroid vascularity in Graves’ disease following propranolol treatment. VIII International Thyroid Congress, Sydney, 1980 (Abstract 128).Google Scholar
  29. 29.
    Rekonen A., Kuikka J., Isomäki A.M., Nordman E. The use of 133Xe clearance method in measurement of the blood flow in thyroid nodules. Ann. Clin. Res. 5: 220, 1973.PubMedGoogle Scholar
  30. 30.
    Goldman H. Effect of acute stress on the pituitary gland: endocrine gland blood flow. Endocrinology 72: 588, 1963.PubMedCrossRefGoogle Scholar
  31. 31.
    Solomon D.H., Prujan R.L., Triplett H.W. Effect of thyrotropin on fractional blood flow of chick thyroid gland. Am. J. Physiol. 205: 549, 1963.PubMedGoogle Scholar
  32. 32.
    Clayton J.A., Szego C.M. Depletion of rat thyroid serotonin accompanied by increased blood flow as an acute response to thyroid-stimulating hormone. Endocrinology 80: 689, 1967.PubMedCrossRefGoogle Scholar
  33. 33.
    Kapitola J., Schüllerová M., Schreiberová O., Vilimovská D., Josifko M. Relation of TSH concentration in blood to the radioactive rubidium 86Rb uptake in the thyroid gland of rats: evidence of TSH regulatory effect on thyroid gland blood flow. Acta Endocrinol. (Kbh.) 77: 266, 1974.Google Scholar
  34. 34.
    Myant N.B., Pochin E.E., Goldie E.A.G. The plasma iodide clearance rate of the human thyroid. Clin. Sci. 8:109, 1949.PubMedGoogle Scholar
  35. 35.
    Pochin E.E. Investigation of thyroid function and disease with radioactive iodine. Lancet 259: 41, 1950.CrossRefGoogle Scholar
  36. 36.
    Berson S.A., Yalow R.S., Sorrentino J., Roswit B. The determination of thyroidal and renal plasma I131 clearance rates as a routine diagnostic test of thyroid dysfunction. J.Clin. Invest. 37:141, 1952.CrossRefGoogle Scholar
  37. 37.
    Monkus E.F., Reineke E.P. Thyroid circulation in the rabbit including arteriovenous difference. Am. J. Physiol. 192:268, 1958.PubMedGoogle Scholar
  38. 38.
    Alexander W.D., Koutras D.A., Crooks J., Buchanan W.W., Macdonald E.M., Richmond M.H., Wayne E.J. Quantitative studies of iodine metabolism in thyroid disease. Q. J. Med. 37:281, 1962.Google Scholar
  39. 39.
    Wolff J. Transport of iodide and other anions in the thyroid gland. Physiol. Rev. 44: 45, 1964.PubMedGoogle Scholar
  40. 40.
    DeGroot L.J. Kinetic analysis of iodine metabolism. J. Clin. Endocrinol. Metab. 26: 149, 1966.PubMedCrossRefGoogle Scholar
  41. 41.
    Söderberg U. Short term reactions in the thyroid gland. Acta Physiol. Scand 42: Suppl. 147, 1958.Google Scholar
  42. 42.
    Wollman S.H., Reed F.E. Transport of radioiodide between thyroid gland and blood in mice and rats. Am. J. Physiol. 196: 113, 1959.PubMedGoogle Scholar
  43. 43.
    Pittman Jr J.A., Dailey G.E., Beschi R. Changing normal values for thyroidal radioiodine uptake. N. Engl. J. Med. 280: 1431, 1969.PubMedCrossRefGoogle Scholar
  44. 44.
    Brismar B., Bergenwald L., Cronestrand R., Jorfelt L., Juhlin-Dannfelt A. The cardiovascular effects of neuroptanaesthesia. Acta Anaestesiol. Scand. 21: 100, 1977.CrossRefGoogle Scholar
  45. 45.
    Brismar B. Leg blood flow and central circulation during vascular surgery. Dissertation. Stockholm, 1976, p. 17, 29.Google Scholar
  46. 46.
    Shinaberger J.H., Bruner H.D. Blood flow in the thyroid gland of the dog. Fed. Proc. 15: 483, 1956 (Abstract).Google Scholar
  47. 47.
    Means J.H. The thyroid and its diseases, ed. 2. J.B. Lippincott Co., Philadelphia, 1948, p. 4.Google Scholar
  48. 48.
    Best C.H., Taylor N.B. The physiological basis of medical practice, ed. 4. Balliere, Tindall & Cox, London, 1945, p. 671.Google Scholar
  49. 49.
    Wollman S.H., Herveg J.P., Zeligs J.D., Ericson L.E. Blood capillary enlargement during the development of thyroid hyperplasia in the rat. Endocrinology 103: 2306, 1978.PubMedCrossRefGoogle Scholar

Copyright information

© Italian Society of Endocrinology (SIE) 1981

Authors and Affiliations

  • Lennart Tegler
    • 1
  • J. Gillquist
    • 1
  • B. Anderberg
    • 1
  • B. Lundström
    • 1
  • H. Johansson
    • 1
  1. 1.Departments of Internal Medicine, Surgery, Clinical Chemistry, and AnesthesiologyUniversity HospitalLinköpingSweden

Personalised recommendations