Vitti P, Martino E, Aghini-Lombardi F, Rago T, Antonangeli L, Maccherini D, Nanni P, Loviselli A, Balestrieri A, Araneo G
Istituto di Endocrinologia, University of Pisa, Italy.
J Clin Endocrinol Metab. 1994 Aug;79(2):600-3. doi: 10.1210/jcem.79.2.8045982.
Thyroid ultrasound was used to measure thyroid volume in children and compared with thyroid palpation for the assessment of the prevalence of goiter in an area of mild iodine deficiency. School children, 6-14 yr old, were from control areas (n = 2693; urinary iodine excretion, 110 micrograms/L) or from an area of mild iodine deficiency (IDA; n = 278; urinary iodine excretion, 72 micrograms/L). Thyroid volume determined by ultrasound in control children increased with age (r = 0.62; P < 0.0001) and was significantly correlated with height (r = 0.51; P < 0.0001) and body weight (r = 0.126; P < 0.0001). Both median and mean thyroid volumes were greater in IDA children than in controls. The prevalence of goiter determined by ultrasound was 68 of 268 children (25.3%) in IDA and 105 of 2693 children (3.9%) in the control area (chi 2 = 204; P < 0.0001). Thyroid enlargement, as assessed by palpation, was found in 59 of 268 children (22%) in the IDA group and in 165 of 2693 (6.1%) subjects in the control area (chi 2 = 88; P < 0.0001). Some subjects of the IDA who were judged goitrous by palpation (11.2%) had a normal thyroid volume at ultrasound, and 12.7% of subjects with an abnormal thyroid volume at ultrasound were judged nongoitrous by palpation. In conclusion, 1) thyroid volume in children, as assessed by ultrasound, increases with age and is closely related to the parameters of body growth; 2) in every age group, thyroid ultrasound shows greater thyroid volume in an IDA group than in controls; and 3) a discrepancy between palpation and ultrasound is found in 23.9% of children living in an IDA, confirming that palpation is relatively inaccurate for assessing the prevalence of goiter in mild iodine deficiency. These data indicate that thyroid volume measurement by ultrasound in children provides a useful tool for the assessment of goiter in mild iodine deficiency.
采用甲状腺超声测量儿童甲状腺体积，并与甲状腺触诊法进行比较，以评估轻度碘缺乏地区甲状腺肿的患病率。6至14岁的学龄儿童来自对照地区（n = 2693；尿碘排泄量为110微克/升）或轻度碘缺乏地区（碘缺乏病，IDA；n = 278；尿碘排泄量为72微克/升）。对照儿童通过超声测定的甲状腺体积随年龄增长而增加（r = 0.62；P < 0.0001），并且与身高（r = 0.51；P < 0.0001）和体重（r = 0.126；P < 0.0001）显著相关。IDA儿童的甲状腺体积中位数和平均值均高于对照组。通过超声测定，IDA组268名儿童中有68名（25.3%）患有甲状腺肿，而对照地区2693名儿童中有105名（3.9%）患有甲状腺肿（χ2 = 204；P < 0.0001）。通过触诊评估，IDA组268名儿童中有59名（22%）甲状腺肿大，对照地区2693名受试者中有165名（6.1%）甲状腺肿大（χ2 = 88；P < 0.0001）。一些通过触诊判断为甲状腺肿的IDA受试者（11.2%）超声检查时甲状腺体积正常，而超声检查甲状腺体积异常的受试者中有12.7%通过触诊判断为非甲状腺肿。总之，1）通过超声评估，儿童甲状腺体积随年龄增长而增加，并且与身体生长参数密切相关；2）在每个年龄组中，IDA组儿童的甲状腺超声显示体积大于对照组；3）在IDA地区生活的儿童中，23.9%的儿童触诊与超声检查结果存在差异，证实触诊在评估轻度碘缺乏地区甲状腺肿患病率方面相对不准确。这些数据表明，通过超声测量儿童甲状腺体积为评估轻度碘缺乏地区的甲状腺肿提供了一种有用的工具。
