THYROID VOLUME IN CHILDREN

Abstract

Goiter grading according to WHO standards is a rather crude method used for population studies mainly. In the individual child where usually smaller goiters of grade la and Ib are diagnosed it might be difficult to define absence or presence of goiter by palpation and inspection alone. The purpose of this investigation was to obtain normal thyroid volumes by means of ultrasonography in healthy children of various ages and to compare these volumes with a group of goitrous children. A total of 621 children (322 girls, 294 boys) of 6 to 16 years of age was investigated. 278 (157 girls, 121 boys) had a goiter on physical examination. Ultrasonography was performed at school using a portable realtime scanner with 4 MHZ linear transducer. Volume was estimated on the basis of ellipsoid thyroid configuration. In healthy boys total thyroid volume increased from 1.8 ± 0.6 (M±SD) to 8.4 ± 3.4 ml from 6 to 16 years respectively, in girls the volume changed from 2.3 ± 1.3 to 10.5 ± 5.1 ml from 6 to 15 years respectively. Goitrous children had larger volumes. There was however a strong tendency for overdiagnosis on clinical basis. A short obese neck prevents the goiter from clinical detection whereas a rather long and lean neck may lead to clinical overdiagnosis. In summary normal thyroid volumes of children were provided by means of sonography which represents the best suitable method to assess volume changes following treatment procedures.