Chun Sangwoo, Lee Young Seok, Yu Jeesuk
Department of Pediatrics, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea.
Department of Radiology, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea.
Ann Pediatr Endocrinol Metab. 2021 Mar;26(1):53-59. doi: 10.6065/apem.2040120.060. Epub 2021 Mar 31.
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.
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.
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.
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.
甲状腺发育不全是永久性先天性甲状腺功能减退最常见的病因之一。甲状腺超声检查或扫描用于检测甲状腺发育不全。我们分析了甲状腺超声检查和扫描在诊断甲状腺发育不全中的敏感性和特异性，以确定每种甲状腺成像方法的临床实用性。
对61例7岁以下儿童进行甲状腺扫描检查。本研究纳入了19例最初经甲状腺扫描被诊断为甲状腺发育不全的患者，如异位、半侧发育不全或发育不全。回顾了甲状腺成像研究的临床特征和结果。
最初，甲状腺扫描结果被解释为异位（n = 9）、半侧发育不全（n = 1）和未显影（n = 9）。相比之下，甲状腺超声检查结果为甲状腺正常（n = 5）、异位（n = 6）和发育不全（n = 8）。在复查两项检查结果后，最终成像诊断如下：甲状腺正常（n = 5）、半侧发育不全（n = 1）、异位（n = 9，包括2例双侧异位）、发育不全（n = 3）和发育不全（n = 1）。甲状腺超声检查在检测正常甲状腺的存在方面显示出更高的敏感性和特异性。甲状腺扫描在检测异位方面表现更好。在最初经超声检查被解释为发育不全的8例患者中，4例被确认为异位，1例被确认为发育不全。
本研究表明，甲状腺超声检查作为检测正常大小的正位甲状腺的一线成像检查很有用。如果超声检查怀疑有发育不全或发育不全，应进行甲状腺扫描以检查是否存在异位。
