Chiri Charlotte, Rapilat Daniela, Avni Freddy, Lefèvre Christine, Labreuche Julien, Lerisson Héloïse, Tillaux Céline, El Fayoumi Mohamed, Boutry Nathalie
Service d'Imagerie de l'Enfant, hôpital Jeanne de Flandre, CHRU de Lille, Lille, France.
Unité d'Endocrinologie Pédiatrique, hôpital Jeanne de Flandre, CHRU de Lille, Lille, France.
J Ultrasound Med. 2025 Feb;44(2):277-284. doi: 10.1002/jum.16603. Epub 2024 Oct 15.
To demonstrate the usefulness of ultrasonography in detecting knee ossification centers in infants with permanent congenital hypothyroidism (PCH).
From 2011 to 2021, all infants with PCH referred for thyroid ultrasound also underwent left knee ultrasound and radiography on the same day. Knee radiographs were compared with knee sonograms. Two pediatric radiologists reviewed the consensus knee radiographs and sonograms to identify femoral and tibial epiphyseal ossification centers (presence/absence). The concordance between ultrasonography and radiography was assessed. Another radiologist conducted a second late review to evaluate interobserver agreement.
We identified 125 patients (65 girls, 60 boys) with a mean age of 24 days (5 days-5 months). On scintigraphy, the thyroid was in place in 66.4%, ectopic in 24%, and absent in 9.6% of patients. The femoral center was observed in 108 patients (86.4%) via sonography and 106 patients (84.8%) via radiography. The tibial center was observed in 84 patients (67.2%) via sonography and radiography. Both femoral and tibial centers were present on sonography and radiography in 84 patients (67.2%). A single nucleus was present in 24 patients (19.2%) on sonography and 22 patients (17.6%) on radiography; it corresponded to the femoral center in all patients. The concordance between ultrasonography and radiography was 99% and 100%, respectively, for the detection of the femoral and tibial centers. Interobserver agreement was substantial to almost perfect for both ultrasonography and radiography.
Ultrasonography is as effective as radiography in detecting knee ossification centers in PCH. It can be performed at the same time as thyroid examination, in place of radiography.
证明超声检查在检测永久性先天性甲状腺功能减退症（PCH）婴儿膝关节骨化中心方面的实用性。
2011年至2021年，所有因甲状腺超声检查转诊的PCH婴儿在同一天也接受了左膝关节超声检查和X线摄影。将膝关节X线片与膝关节超声图像进行比较。两名儿科放射科医生对一致的膝关节X线片和超声图像进行审查，以确定股骨和胫骨骨骺骨化中心（存在/不存在）。评估超声检查与X线摄影之间的一致性。另一名放射科医生进行了第二次后期审查，以评估观察者间的一致性。
我们确定了125例患者（65名女孩，60名男孩），平均年龄为24天（5天至5个月）。在闪烁扫描中，66.4%的患者甲状腺位置正常，24%异位，9.6%缺失。通过超声检查在108例患者（86.4%）中观察到股骨中心，通过X线摄影在106例患者（84.8%）中观察到。通过超声检查和X线摄影在84例患者（67.2%）中观察到胫骨中心。超声检查和X线摄影均显示84例患者（67.2%）股骨和胫骨中心均存在。超声检查中有24例患者（19.2%）出现单个核，X线摄影中有22例患者（17.6%）出现；在所有患者中均对应于股骨中心。超声检查与X线摄影在检测股骨和胫骨中心方面的一致性分别为99%和100%。超声检查和X线摄影的观察者间一致性均为高度一致至几乎完全一致。
在检测PCH婴儿膝关节骨化中心方面，超声检查与X线摄影同样有效。它可以与甲状腺检查同时进行，替代X线摄影。
