Ueda D
Department of Pediatrics, Asahikawa Medical College, Japan.
Hokkaido Igaku Zasshi. 1991 Jan;66(1):67-78.
The thyroid gland and pancreas were ultrasonographically examined in order to determine their normal sizes in children. In 418 healthy children the thickness and width of the right and left lobes of the thyroid gland were measured at the transverse section of the neck. In 145 healthy children the long axis and short axis diameters of the profile of the head and body of the pancreas were measured by the sagittal scanning at the epigastrium. The mean +/- standard deviations as a function of height was determined as the normal size in children. In 23 patients with congenital hypothyroidism and hyperthyropinanemia ultrasonographic findings of the thyroid gland were classified into 4 groups: large thyroid gland image, normal thyroid gland image, small thyroid gland image, and no image of the thyroid gland. The patients in the no image of the thyroid gland group revealed extremely high serum thyrotropin level at the initial diagnosis, and they needed a total replacement dose of l-T4. Thyroid scintigraphy was carried out in 7 of the 23 patients. The ultrasonographic findings coincided with the scintigrams in all 7 patients. We concluded that no image of the thyroid gland by ultrasonography was in accord with thyroid aplasia or ectopic thyroid gland, and large thyroid gland image by ultrasonography was goitorous congenital hypothyroidism. In 18 patients with insulin-dependent diabetes mellitus (IDDM) the size of the pancreas was smaller than in the healthy controls. However there was no correlation between the size of the pancreas and clinical parameters, such as duration of IDDM, mean HbA1 and the insulin dose. In 31 patients with growth hormone deficiency undergoing growth hormone therapy, pancreas size was not different from the healthy controls. Thus it was suggested that in IDDM patients the size of the pancreas was small at the time of onset, and that the growth hormone had morphologically no influence on the pancreas in patients with growth hormone deficiency.
为确定儿童甲状腺和胰腺的正常大小，对其进行了超声检查。在418名健康儿童中，于颈部横切面测量甲状腺左右叶的厚度和宽度。在145名健康儿童中，于上腹部进行矢状面扫描，测量胰腺头部和体部轮廓的长轴和短轴直径。将身高函数的均值±标准差确定为儿童的正常大小。对23例先天性甲状腺功能减退症和甲状腺激素缺乏性贫血患者，甲状腺超声检查结果分为4组：甲状腺大图像、甲状腺正常图像、甲状腺小图像和无甲状腺图像。无甲状腺图像组患者初诊时血清促甲状腺激素水平极高，需要l-T4的全替代剂量。23例患者中的7例进行了甲状腺闪烁显像。7例患者的超声检查结果与闪烁显像结果均相符。我们得出结论，超声检查无甲状腺图像与甲状腺发育不全或异位甲状腺相符，超声检查甲状腺大图像为甲状腺肿性先天性甲状腺功能减退症。18例胰岛素依赖型糖尿病（IDDM）患者的胰腺大小小于健康对照。然而，胰腺大小与IDDM病程、平均糖化血红蛋白（HbA1）和胰岛素剂量等临床参数之间无相关性。31例接受生长激素治疗的生长激素缺乏患者的胰腺大小与健康对照无差异。因此，提示IDDM患者发病时胰腺较小，生长激素对生长激素缺乏患者的胰腺形态无影响。
