Department of Child Health, Royal Hospital for Sick Children, Dalnair Street, Yorkhill, Glasgow, Lanarkshire, G3 8SJ, UK.
Pediatr Radiol. 2010 May;40(5):725-31. doi: 10.1007/s00247-009-1492-2. Epub 2010 Jan 12.
Thyroid imaging is of proven help in establishing a diagnosis of congenital hypothyroidism in infants. US often shows tissue in the thyroid fossa when radionuclide scintigraphy reveals only ectopic uptake.
Our hypothesis was that the use of US alone could lead to the mistaken diagnosis of normal or dysplastic thyroid in cases of scintigraphy-proven thyroid ectopia.
We undertook a detailed retrospective review and analysis of imaging and concurrent biochemistry in infants with thyroid ectopia, confirmed by radionuclide scintigraphy.
Eighteen infants had thyroid ectopia; ten of the original US reports had suggested that cervical thyroid tissue was present. Review showed bilateral tissue in the thyroid fossa in all that was non-thyroidal in nature since, apart from showing no radionuclide uptake, it exhibited some or all of the following typical features: hyperechogenicity, heterogeneity, small size, poor vascularity, and anechoic and/or hypoechoic cysts. Also, extension of the tissue both around and behind the large cervical blood vessels was a universal finding.
Considerable experience is required to interpret neonatal thyroid US. We caution against diagnosing a dysplastic/hypoplastic thyroid gland in situ on the basis of US alone, particularly if the tissue exhibits any of the non-thyroidal features described.
甲状腺成像在确定婴儿先天性甲状腺功能减退症的诊断中具有一定的帮助。当放射性核素闪烁显像仅显示异位摄取时，超声通常可显示甲状腺窝内的组织。
我们的假设是，在放射性核素闪烁显像证实甲状腺异位的情况下，单独使用超声可能会导致对正常或发育不良甲状腺的误诊。
我们对放射性核素闪烁显像证实的甲状腺异位的婴儿进行了详细的回顾性影像学和同时进行的生化分析。
18 名婴儿患有甲状腺异位；最初的超声报告中有 10 份报告提示存在颈部甲状腺组织。复查显示，所有非甲状腺性质的甲状腺窝内均有双侧组织，因为除了没有放射性核素摄取外，还表现出以下一种或多种典型特征：高回声、异质性、体积小、血管分布不良、无回声和/或低回声囊肿。此外，组织在大的颈部血管周围和后面的延伸是普遍存在的。
解读新生儿甲状腺超声需要丰富的经验。我们警告不要仅根据超声诊断发育不良/发育不全的甲状腺原位，特别是如果组织表现出任何描述的非甲状腺特征。
