Related Experiment Video
Updated: Jan 11, 2026
Author Spotlight: Integrating Ultrasound Imaging with Biochemical Markers for Thyroid Disease Diagnosis
Published on: February 9, 2024
The effects of iodinated contrast media exposure on thyroid functions after angiography in patients with subclinical
Zeynep Ece Demirbaş1, Fatma Can2
1Department of Internal Medicine, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Tıbbiye Cad. No:13 Selimiye, Uskudar, Istanbul, 344668, Turkey. zeynepece@gmail.com.
Insights
Iodinated contrast media (ICM) exposure in subclinical hyperthyroidism patients often results in stable thyroid function or a euthyroid state. However, some patients may develop clinical hyperthyroidism or hypothyroidism, necessitating careful monitoring.
Area of Science:
- Endocrinology
- Radiology
- Cardiology
Background:
- Subclinical hyperthyroidism poses challenges in managing patients requiring contrast-enhanced procedures.
- Investigating the impact of iodinated contrast media (ICM) on thyroid function is crucial for this population.
Purpose of the Study:
- To evaluate the effects of ICM exposure on thyroid function in patients with pre-existing subclinical hyperthyroidism.
- To assess changes in thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), and free thyroxine (fT4) levels post-ICM administration.
Main Methods:
- Retrospective analysis of 46 patients with subclinical hyperthyroidism undergoing angiographic procedures.
- Comparison of thyroid function tests (TSH, fT3, fT4) before and after ICM exposure.
- Stratification into low (<200 ml) and high (≥200 ml) ICM volume groups.
Main Results:
- 50% of patients normalized thyroid function (euthyroid), while 41.3% remained subclinically hyperthyroid post-ICM.
- A small percentage developed overt hyperthyroidism (4.3%) or hypothyroidism (4.3%).
- Significant increase in TSH levels observed post-procedure (p<0.01), with no significant changes in fT3 or fT4.
Conclusions:
- ICM exposure in subclinical hyperthyroid patients generally leads to stable or normalized thyroid function.
- Clinical hyperthyroidism or hypothyroidism can occur, highlighting the need for vigilant monitoring.
- Further long-term follow-up is recommended to fully understand the risks associated with ICM in this cohort.
Background:
This study aims to investigate the effects of iodinated contrast media (ICM) exposure on thyroid function in patients with subclinical hyperthyroidism.
Methods:
The study included 46 patients with subclinical hyperthyroidism who presented to the cardiology outpatient clinic and underwent angiographic imaging procedures. Thyroid function tests (TSH, fT3, fT4) of the patients before and after the procedure were analyzed retrospectively. Patients were divided into two groups as low volume (< 200 ml) and high volume (≥ 200 ml) according to the volume of contrast medium received. Pre- and post-procedure comparisons as well as analyses according to low and high-volume exposure were performed.
Results:
After the procedure, 50% of the patients became euthyroid and 41.3% remained in the same group (subclinical hyperthyroidism). 2 patients (4.3%) developed clinical hyperthyroidism, and another 2 patients (4.3%) developed clinical hypothyroidism. TSH values increased significantly after the procedure (p < 0.01), but no significant change was observed in fT3 and fT4 values.
Conclusions:
In patients with subclinical hyperthyroidism, thyroid function mostly remained stable or became euthyroid after ICM exposure. However, a group of patients developed clinical hypothyroidism or hyperthyroidism. These results suggest that patients with subclinical hyperthyroidism should be closely monitored when using ICM. Long-term follow-up will contribute to a better understanding of the possible risks in this patient group.
Related Concept Videos
01:30Radiological Investigation I: X-ray and CT
01:20Synthesis and Regulation of Thyroid Hormones
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
01:27Imaging Studies III: Computed Tomography
01:28Imaging Studies for Cardiovascular System V: CT
01:13Radiological Investigation III: Pulmonary Angiogram and PET Scan
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...
01:23The Thyroid Gland
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...