Abstract
To evaluate the association between thyroid echogenicity and heterogeneity seen on ultrasonography (US) and thyroid function in pediatric and adolescent populations with autoimmune diffuse thyroid diseases (AITD). From 2000 to 2020, we reviewed thyroid ultrasound (US) images and thyroid function statuses in 133 children and adolescent AITD patients. Our review of the images focused on decreased echogenicity and heterogeneity, which were classified into four grades. Among patients with overt hypothyroidism or overt hyperthyroidism, 94.2% (65/69) showed a US grade of 3 or 4. In patients with subclinical hyper/hypothyroidism or euthyroidism, 45.3% (29/64) showed grades 1 or 2. There were no overt hyper/hypothyroidism patients with US grade 1. When we compared US grades according to thyroid status, more severe thyroid dysfunction was significantly associated with higher US grade (p = 0.047). Thyroid stimulating hormone (TSH) level differed significantly according to US grades when we evaluated hyperthyroid (p = 0.035) and hypothyroid (p = 0.027) states independently. 11 patients showed both US grade and thyroid function status changes on follow-up US. In children and adolescent AITD patients, there was an association between decreased echogenicity and heterogeneity on US and thyroid dysfunction.
Highlights
To evaluate the association between thyroid echogenicity and heterogeneity seen on ultrasonography (US) and thyroid function in pediatric and adolescent populations with autoimmune diffuse thyroid diseases (AITD)
AITD diagnosis was made according to clinical history, symptoms, thyroid function test (TFT) results, and confirmation of antithyroid peroxidase autoantibodies (TPOAb) or serum Thyroid stimulating hormone (TSH) receptor antibodies (TRAb)
Eight (6%), 25 (18.9%), 45 (33.8%), and 55 (41.3%) patients were classified into Grade 1 (G1), G2, G3, and G4, respectively
Summary
To evaluate the association between thyroid echogenicity and heterogeneity seen on ultrasonography (US) and thyroid function in pediatric and adolescent populations with autoimmune diffuse thyroid diseases (AITD). Decreased echogenicity of the thyroid gland on US is associated with overt hypothyroidism[4,10], and changes in echogenicity have been reported in subclinical hypothyroidism as w ell[5,6,7,8,9]. Another general population study found that thyroid gland heterogeneity on US is related to thyroid dysfunction regardless of whether it is accompanied by h ypoechogenicity[5].
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