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Diagnostic performance of thyroid ultrasonography screening in pediatric patients with a hypothyroid, hyperthyroid or euthyroid goiter

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Abstract

Background

Goiter is frequently the first indicator of thyroid disease in children.

Objective

To evaluate the usefulness of ultrasonography (US) in the identification of potential malignant nodules and autoimmune thyroiditis in children with diffuse goiter.

Materials and methods

This study consisted of 113 patients <20 years with a diffuse goiter who underwent thyroid US. Parenchymal echogenicity and the presence of nodules and abnormal lymph nodes were evaluated on US; if a thyroid nodule was detected, its characteristics were analyzed. The diagnostic accuracy of the US findings in the diagnosis of autoimmune thyroid disease was assessed.

Results

Thyroid nodules were detected on US in 72 of the 113 (63.7%) patients. Of these, 65 (90.3%) had probably benign nodules and 4 (5.6%) patients had nodules suspicious of malignancy. The remaining had indeterminate nodules only. In one child with suspected malignant nodules, papillary thyroid cancer with coexisting autoimmune thyroiditis was confirmed. Hypoechogenicity was visualized in 23 (88.5%) patients with autoimmune thyroiditis and 12 (85.7%) with Graves disease. The sensitivity and specificity of micronodulation for autoimmune thyroiditis were 53.9% and 98.3%, respectively.

Conclusion

Although the potential for malignant nodules is relatively low in children with diffuse goiter, US can detect focal thyroid disease and characterize the nodules. US thus plays a useful role in excluding autoimmune thyroiditis in this population.

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Authors and Affiliations

  1. Department of Radiology, Yeouido St. Mary’s Hospital, The Catholic University of Korea, 63-10 Yeoudodong-ro, Seoul, South Korea, 150-713

    Soo Jin Lee, Gye-Yeon Lim & Jee Young Kim

  2. Department of Pediatrics, Yeouido St. Mary’s Hospital, The Catholic University of Korea, Seoul, South Korea

    Min Ho Chung

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  1. Soo Jin Lee
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  2. Gye-Yeon Lim
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  3. Jee Young Kim
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  4. Min Ho Chung
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Correspondence to Gye-Yeon Lim.

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Lee, S.J., Lim, GY., Kim, J.Y. et al. Diagnostic performance of thyroid ultrasonography screening in pediatric patients with a hypothyroid, hyperthyroid or euthyroid goiter. Pediatr Radiol 46, 104–111 (2016). https://doi.org/10.1007/s00247-015-3435-4

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  • DOI: https://doi.org/10.1007/s00247-015-3435-4

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