Abstract

Ultrasonography (US) is the imaging method of choice for evaluating the pediatric thyroid gland, complemented by scintigraphy and thyroid function tests, especially when evaluating children with suspected congenital hypothyroidism, goiter, infectious or autoimmune diseases, or neoplasm. Diagnostic considerations in newborns with congenital hypothyroidism mainly include dysgenesis, dyshormonogenesis, transient hypothyroidism and central (hypophyseal) hypothyroidism. The midline of the neck should be scrutinized for thyroid tissue from the floor of the mouth to the thoracic inlet. Cystic and echogenic ultimobranchial remnants should not be misinterpreted as orthotopic thyroid tissue. Diffuse thyroid diseases affect older children; these comprise Hashimoto and Graves diseases and infectious thyroiditis and exhibit features similar to those in adults. It is important to note that the diffuse sclerosing variant of papillary thyroid cancer can complicate thyroiditis and should not be confused with Hashimoto disease. In children with solid nodules the threshold for fine-needle aspiration biopsy or surgery should be lower compared to adults because of a higher likelihood of malignancy compared with adults. Biopsy should be considered in nodules with suspicious ultrasonographic features, even when smaller than 1 cm. Adult classification systems of thyroid nodules, although useful, are not sufficient to safely discriminate the nodules’ likelihood of malignancy in children. We describe key sonographic findings and suggest a standard checklist that might be considered while performing and interpreting thyroid US in neonates and children.

中文翻译：

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小儿甲状腺超声：放射科医生的清单。

摘要

超声检查（US）是评估儿科甲状腺的首选成像方法，辅以闪烁显像和甲状腺功能检查，尤其是在评估可疑先天性甲状腺功能减退，甲状腺肿，感染性或自身免疫性疾病或肿瘤的儿童时。患有先天性甲状腺功能减退症的新生儿的诊断考虑因素主要包括发育不全，营养不良，短暂性甲状腺功能减退和中枢性（垂体性）甲状腺功能减退。应仔细检查颈部中线从口底到胸腔入口的甲状腺组织。囊性和回声性终末支气管残余不应误解为原位甲状腺组织。弥漫性甲状腺疾病影响年龄较大的儿童；这些疾病包括桥本和Graves疾病以及传染性甲状腺炎，并表现出与成年人相似的特征。重要的是要注意，乳头状甲状腺癌的弥漫性硬化变型会使甲状腺炎复杂化，不应与桥本氏病混淆。对于结节结节的儿童，与成人相比，细针穿刺活检或手术的阈值应低于成人，因为与成人相比，发生恶性肿瘤的可能性更高。超声检查可疑结节，即使小于1 cm也应考虑活检。成人甲状腺结节分类系统虽然有用，但不足以安全地区分儿童中结节的恶性可能性。我们描述了关键的超声检查结果，并提出了在新生儿和儿童中进行和解释甲状腺US时可能要考虑的标准检查清单。