Ann Pediatr Endocrinol Metab.  2021 Mar;26(1):53-59. 10.6065/apem.2040120.060.

Thyroid imaging study in children with suspected thyroid dysgenesis

• Chun S
• Lee YS
• Yu J

• KMID: 2514153
• DOI: http://doi.org/10.6065/apem.2040120.060

Abstract

Purpose
Thyroid dysgenesis is one of the most common causes of permanent congenital hypothyroidism. Thyroid ultrasonography or scan is used to detect thyroid dysgenesis. We analyzed the sensitivity and specificity of thyroid ultrasonography and scan in diagnosing thyroid dysgenesis to determine the clinical utility of each thyroid imaging method.
Methods
Sixty-one patients younger than 7 years of age were investigated via thyroid scan. Nineteen patients who were initially interpreted as having thyroid dysgenesis, such as ectopia, hemiagenesis, or aplasia, by thyroid scan were included in the study. Clinical characteristics and findings of a thyroid imaging study were reviewed.
Results
Initially, thyroid scan results were interpreted as ectopia (n=9), hemiagenesis (n=1), and nonvisualization (n=9). In contrast, the results of thyroid ultrasonography were normal thyroid gland (n=5), ectopia (n=6), and hypoplasia (n=8). After reviewing the results of both studies, final imaging diagnoses were as follows: normal thyroid gland (n=5), hemiagenesis (n=1), ectopia (n=9) including 2 dual ectopy, hypoplasia (n=3), and aplasia (n=1). Thyroid ultrasonography showed higher sensitivity and specificity in detecting presence of normal thyroid gland. Thyroid scan was better to detect ectopia. Among 8 patients who were initially interpreted as having hypoplasia by ultrasonography, 4 were confirmed as ectopia and one as aplasia.
Conclusion
This study showed that thyroid ultrasonography is useful as the first-line imaging study to detect normal-sized eutopic thyroid gland. Thyroid scan should be performed to investigate the presence of ectopia if hypoplasia or aplasia is suspected by ultrasonography.

Keyword

Thyroid dysgenesis; Ultrasonography; Scan

Figure

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  Fig. 1. Flow diagram of the study. A total of 19 participants was included in the study after excluding 42 individuals who revealed normal-positioned, normal-sized thyroid gland on thyroid scan.

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  Fig. 2. Grouping of the patients according to the final diagnosis based on the results of thyroid scan and ultrasonography (US). Initial interpretations of thyroid scan and thyroid ultrasonography were changed as follows: ectopia (n=9), hemiagenesis (n=1), hypoplasia (n=3), aplasia (n=1), and normal (n=5).

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  Fig. 3. There were 2 patients with dual ectopy (A, B) and 1 patient with hemiagenesis (C). Dual ectopia was found at the level of lingual/sublingual and submandibular areas (A) and sublingual areas (B), respectively.

Reference

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