Sonographic evaluation of children with congenital hypothyroidism

Abstract

ObjectiveTo establish benchmarks and study some sonographic characteristics of the thyroid gland in a group of euthyroid children aged up to 5 years as compared with age-matched children with congenital hypothyroidism.Materials and MethodsThirty-six children (17 female and 19 male) aged between 2 months and 5 years were divided into two groups – 23 euthyroid children and 13 children with congenital hypothyroidism – and were called to undergo ultrasonography.ResultsIn the group of euthyroid children (n = 23), mean total volume of the thyroid gland was 1.12 mL (minimum, 0.39 mL; maximum, 2.72 mL); a homogeneous gland was found in 17 children (73.91%) and 6 children (26.08%) had a heterogeneous gland. In the group of children with congenital hypothyroidism (n = 13), mean total volume of the thyroid gland was 2.73 mL (minimum, 0.20 mL; maximum, 11.00 mL). As regards thyroid location, 3 patients (23.07%) had ectopic thyroid, and 10 (69.23%) had topic thyroid, and out of the latter, 5 had a homogeneous gland (50%) and 5, a heterogeneous gland (50%). In the group with congenital hypothyroidism, 6 (46.15%) children had etiological diagnosis of dyshormoniogenesis, 3 (23.07%), of ectopic thyroid, and 4 (30.76%), of thyroid hypoplasia.ConclusionThyroid ultrasonography is a noninvasive imaging method, widely available, easy to perform and for these reasons could, and should, be performed at any time, including at birth, with no preparation or treatment discontinuation, to aid in the early etiological definition of congenital hypothyroidism.

DUOX2 and DUOXA2 Variants Confer Susceptibility to Thyroid Dysgenesis and Gland-in-situ With Congenital Hypothyroidism

“…3The morphological classification of thyroid is as follows (shown by ultrasonography or technetium-99 m thyroid scanning): (a) GIS means a child diagnosed with CH, accompanied by normal thyroid anatomy and imaging findings; (b) athyreosis is defined as failure to show any thyroid tissue on ultrasonography and technetium thyroid scans; (c) ectopia refers to the absence of thyroid tissue in normal thyroid anatomical structure, but appeared in other areas; (d) hypoplasia refers to unilateral and/or bilateral thyroid gland not reaching normal size and lacking normal shape (27). Thyroid morphology was classified by thyroid ultrasonography and technetium thyroid scans (28,29). In addition, we excluded children with chromosomal abnormalities, children with central hypothyroidism or associated syndromes and offspring of mothers with Graves' disease.…”

Ultrasound measurement of thyroid volume in euthyroid children under 3 years of age

“…It enables us to distinguish between normal and abnormal structures in the thyroid, as well as to identify dysgenesis (ectopia, agenesis, and hypoplasia). If necessary in order to clarify the etiology of congenital hypothyroidism, it is possible to select specific cases to undergo further tests, such as molecular tests and other imaging examinations ( 9 , 10 ) .…”

“…All children underwent ultrasound of the thyroid to assess the characteristics of the gland, including its position, volume, texture, and other aspects ( Figures 1 and 2 ). The examinations were performed with the patients in the supine position, with extension of the neck to facilitate the anatomical analysis ( 9 , 10 ) . In the initial evaluation of the thyroid, its lobes and isthmus were characterized, as were its position in the neck, echotexture, dimensions, and volume.…”

“…Total thyroid volume was determined by adding the volumes of both lobes, the isthmus being disregarded because it is very small at these ages. Lesions in the thyroid parenchyma were recorded separately ( 9 , 10 ) .…”

“…From a technical and evolutive perspective, thyroid ultrasound enables the detection of ectopic and topical thyroids; precise volume calculation of its lobes and isthmus; and characterization of the parenchyma and its abnormalities. Thyroid volume is influenced by various factors, including age, dietary iodine intake, and anthropometric characteristics ( 9 , 10 ) .…”