Pediatric endocrinology

The diagnosis of diffuse goitre by ultrasound imaging in children

In order to find an easy and accurate procedure for diagnosis of diffuse goitre in children, we examined 50 patients with diffuse goitre using fine needle aspiration biopsy cytology, thyroid antibody detection, thyroid hormone analysis and ultrasound imaging. In the meantime, 109 healthy children (control) were examined by ultrasound imaging. The results showed that thyroid imaging in health children was a smooth echo pattern with stronger homogenous echogram than surrounding muscle tissues. The patients with diffuse goitre showed an abnormally enlarged thyroid volume. In 22 (84.6%) of 26 children with chronic lymphocytic thyroiditis, a varied patch hypoechogenicity was found, of whom 18 (81.8%) had positive results of antibody testing. On the contrary, echo-pattern was normal in 17 (70.8%) of 24 patients with diffuse thyroid proliferation and only the remainder (7/24, 29.1%) had abnormal echo-pattern as well as elevated auto-antibody titers, of whom 2 were confirmed as chronic lymphocytic thyroiditis by a repeat fine needle aspiration biopsy 1 year later. By using combined ultrasound imaging and antibody determination, 92% of the cases with chronic lymphocytic thyroiditis could be diagnosed. Our study suggests that ultrasonic imaging is an easy, non-invasive, reproducible and effective procedure in the differential diagnosis of chronic lymphocytic thyroiditis in children.