Thyroid imaging is indicated to evaluate congenital hypothyroidism during newborn screening or in cases of a palpable thyroid mass in children and adolescents. This pictorial essay reviews the ultrasonography (US) of thyroid diseases in children and adolescents, including normal thyroid gland development, imaging features of congenital thyroid disorders (dysgenesis, [aplasia, ectopy, hypoplasia], dyshormonogenesis, transient hypothyroidism, thyroglossal duct cyst), diffuse thyroid disease (Grave's disease, Hashimoto's thyroiditis, and suppurative thyroiditis), and thyroid nodules. The primary imaging modalities for evaluating thyroid diseases are US and radionuclide scintigraphy. Additionally, US can be used to guide aspiration of detected nodules.
Adolescent ; Child ; Congenital Hypothyroidism/diagnosis/*ultrasonography ; Female ; Graves Disease/diagnosis/ultrasonography ; Hashimoto Disease/diagnosis/ultrasonography ; Humans ; Hypothyroidism/diagnosis/*ultrasonography ; Infant, Newborn ; Male ; Thyroid Dysgenesis/diagnosis/ultrasonography ; Thyroid Nodule/embryology/*ultrasonography ; Thyroiditis/diagnosis/*ultrasonography

Thyroid hemiagenesis is considered to be a rare congenital anomaly, but its incidence is propabley underestimated because the diagnosis is usually incidental. The left lobe is absent four times as often as the right and women are about three times more likely to have this developmental defect. Many of these patients are hyperthyroid or medical attention. We present the case of a 14-year-old women with right thyroid hemiagenesis associated without other thyroid disorders. The diagnosis of hemiagenesis was established by isotope imaging and thyroid ultrasound. In most of the clinical reports on thyroid hemiagenesis, an association with other thyroid disorders was found such as hyperthyroidism, multinodular goitre, hypothyroidism, benign adenama, Graves' disease, acute and subacute thyroiditis, and carcinoma. Even if morphology and function of thyroid gland is normal on diagnosis, a follow-up survey should be recommended.
Adolescent ; Diagnosis ; Female ; Follow-Up Studies ; Graves Disease ; Humans ; Hyperthyroidism ; Hypothyroidism ; Incidence ; Thyroid Gland* ; Thyroiditis, Subacute ; Ultrasonography

Thyroid hemiagenesis is considered to be a rare congenital anomaly, but its incidence is propabley underestimated because the diagnosis is usually incidental. The left lobe is absent four times as often as the right and women are about three times more likely to have this developmental defect. Many of these patients are hyperthyroid or medical attention. We present the case of a 14-year-old women with right thyroid hemiagenesis associated without other thyroid disorders. The diagnosis of hemiagenesis was established by isotope imaging and thyroid ultrasound. In most of the clinical reports on thyroid hemiagenesis, an association with other thyroid disorders was found such as hyperthyroidism, multinodular goitre, hypothyroidism, benign adenama, Graves' disease, acute and subacute thyroiditis, and carcinoma. Even if morphology and function of thyroid gland is normal on diagnosis, a follow-up survey should be recommended.
Adolescent ; Diagnosis ; Female ; Follow-Up Studies ; Graves Disease ; Humans ; Hyperthyroidism ; Hypothyroidism ; Incidence ; Thyroid Gland* ; Thyroiditis, Subacute ; Ultrasonography

PURPOSE: The aim of this study was to validate the superior thyroidal artery mean peak systolic velocity (STA-mPSV) as an alternative to other diagnostic parameters in the differentiation of the causes of thyrotoxicosis in Korean patients. METHODS: This study was conducted with newly diagnosed and untreated thyrotoxic patients. Forty patients were diagnosed with Graves disease (GD) and 20 patients with destructive thyroiditis (DT). Another 60 healthy subjects without thyroid disease participated as the control group. Blood samples were taken to evaluate the thyroid function and thyroid autoantibodies (TRAb). Twenty-four hour radioactive iodine uptake (RAIU) scanning was performed to confirm GD or DT. The STA-mPSV was measured using color Doppler ultrasonography. RESULTS: The STA-mPSV was significantly higher in the untreated GD group than in the DT group (GD, 78.96+/-29.04 cm/sec; DT, 29.97+/-14.67 cm/sec; control, 17.55+/-4.99 cm/sec; P<0.001). The area under the curve (AUC) of the STA-mPSV for the differential diagnosis of untreated GD and DT was 0.9506 (optimal cutoff value, 41.3 cm/sec; sensitivity, 95%, 38/40; specificity, 85%, 17/20) in the receiver operating characteristic analysis. The AUC values of the STA-mPSV, RAIU, and TRAb were 0.9506, 1, and 0.9988, respectively (P=0.159). CONCLUSION: In clinical practice, the STA-mPSV has a diagnostic value similar to that of the TRAb and 24-hour RAIU in the differential diagnosis of newly diagnosed Korean thyrotoxic patients.
Area Under Curve ; Arteries* ; Autoantibodies ; Diagnosis, Differential* ; Graves Disease ; Humans ; Iodine ; ROC Curve ; Sensitivity and Specificity ; Thyroid Diseases ; Thyroid Gland* ; Thyroiditis ; Thyrotoxicosis* ; Ultrasonography, Doppler ; Ultrasonography, Doppler, Color

Graves' disease (GD) is generally presented by thyrotoxicosis with hyperthyroidism, and it is an organ-specific autoimmune disease induced by thyroid-stimulating hormone receptor autoantibodies. However, among diverse etiologies, viral infections have been suggested to trigger or to be involved in the pathogenesis of GD. Hantaan virus infection causing hemorrhagic fever with renal syndrome (HFRS) is common in South Korea and its pathogenesis is suggested to be an immunologic mechanism. We have experienced a patient who was diagnosed as HFRS with thyrotoxicosis. So we herein report the case as GD combined with the hantaan virus infection.
Graves Disease/complications/*diagnosis/ultrasonography ; *Hantaan virus ; Hemorrhagic Fever with Renal Syndrome/complications/*diagnosis ; Humans ; Male ; Radiopharmaceuticals/diagnostic use ; Thyrotoxicosis/diagnosis ; Young Adult

PURPOSE: Graves' disease presenting concurrently with thyroid cancer is a rare condition. The clinical behaviors and the extent of surgery in this condition is still controversial. This study examined the prognostic factors influencing the long-term outcomes as well as the appropriate treatment modalities in patients with Graves' disease presenting concurrently with thyroid cancer. METHODS: Forty nine patients who underwent surgery for thyroid cancer with Graves' disease were enrolled in this study. The outcomes of various types of surgical treatments as well as the factors associated with the long-term outcome were retrospectively analyzed. RESULTS: There were 42 women and 7 men with a median age 39 years (15~70 years). The surgical procedures included a bilateral subtotal thyroidectomy (n=17), a bilateral total thyroidectomy (n=16), and a total and contralateral subtotal thyroidectomy (n=16). The mean follow-up period was 83 months (4~218 months) after surgery. Disease-free survival at 5 and 10 years were 97.6% and 88.9%, respectively. Univariate log-rank survival analyses revealed that the age at diagnosis, the size of the thyroid cancer, capsular invasion, multiplicity, lymph node involvement, and clinical cancer to be poor prognostic factors. However, the extent of the surgical treatment was not significant for survival. CONCLUSION: The prognosis is expected to be poor when thyroid cancer presenting concurrently with Graves' disease is clinically apparent or has invaded the thyroid capsule. Patients with Graves' disease should be screened with ultrasonography to detect thyroid cancer. A total thyroidectomy or completion total thyroidectomy is not necessary in patients who do not have any of the poor prognostic factors, such as incidentally detected microcarcinoma postoperatively.
Diagnosis ; Disease-Free Survival ; Female ; Follow-Up Studies ; Graves Disease* ; Humans ; Lymph Nodes ; Male ; Prognosis ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy ; Ultrasonography

The orbital pseudotumor is non-specific inflammatory disease and is unrelated with specific local or systemic disease. The major symptoms are orbital pain, limitation of the ocular movement and exophthalmos. The inflammatory change can be diffuse within the orbit or may involve a specific structure such as an extraocular muscle or lacrimal gland. It occasionally occurs acutely, but chronically in some cases. It may bring about scarring accompanied by the intraorbital soft tissue including retroorbital fat or extraocular muscles. This can be detected by ultrasound, CT orMRI. The findings by imaging procedures are thickened extraocular muscles, diffuse inflammation of intraorbital soft tissue, enlarged lacrimal gland and enhanced periorbital tissue like "a ring". Sometimes, the focal masses may be seen around the optic nerve, within the retroorbital fat or near the opbital periosteum. The diagnosis of pseudotumor is made by excluding other causes or orbital mass lesions, such as neoplasm, and other causes of orbital inflammation such as Graves' disease and local infection. Treatments are usually used systemic high-dose steroids, additionally surgical excision and radiation. Authors experienced a 52-year old female with progressively enlarged tumor in right orbital area, exophthalmos and loss of sight was treated with surgical excision, and then the defect was reconstructed with the radial forearm free flap successfully.
Cicatrix ; Diagnosis ; Exophthalmos ; Female ; Forearm ; Free Tissue Flaps ; Graves Disease ; Humans ; Inflammation ; Lacrimal Apparatus ; Middle Aged ; Muscles ; Optic Nerve ; Orbit* ; Orbital Pseudotumor* ; Periosteum ; Steroids ; Ultrasonography

We report a case of prenatal diagnosis of fetal congenital goiter at 31weeks of gestation by ultrasonogram and fetal hypothyroidism confirmed at birth as thyroid function test by umbilical cord blood sampling. Maternal Graves' disease and the drugs used to treat hyperthyroidism in pregnant women can affect the fetus, causing hyperthyroidism or hypothyroidism and goiter. Fetal hypothyroidism may be caused by transplacental passage of either maternal thyrotropic-binding inhibitory immunoglobulin(TBII) antibodies or maternal treatment with propylthiouracil(PTU). Untreated fetal hypothyroidism may result in mental retardation, perceptual-motor, visual-spatial, and language developmental problems. In this article fetal thyroid function was not assessed by cordocentesis, but fetal congenital goiter was detected ultrasound. Ultrasound should be used to detect fetal goiter from 20 weeks onward. Fetal goiter should resolve when maternal PTU treatment is decreased. We have diagnosed fetal hypothyroidism in utero by ultrasonography. Significance of in utero management of fetal hypothyroidism is discussed.
Antibodies ; Congenital Hypothyroidism ; Cordocentesis ; Female ; Fetal Blood ; Fetus ; Goiter* ; Graves Disease ; Humans ; Hyperthyroidism* ; Hypothyroidism ; Intellectual Disability ; Language Development ; Mothers* ; Parturition ; Pregnancy ; Pregnant Women ; Prenatal Diagnosis* ; Thyroid Function Tests ; Thyroid Gland ; Ultrasonography

No abstract available.
Anticoagulants/therapeutic use ; Antithyroid Agents/therapeutic use ; Graves Disease/*complications/diagnosis/drug therapy ; Humans ; Infarction/diagnosis/drug therapy/*etiology ; Kidney/*blood supply/radiography ; Male ; Middle Aged ; *Thyroid Gland/radionuclide imaging/ultrasonography ; Thyrotoxicosis/diagnosis/drug therapy/*etiology ; Tomography, X-Ray Computed ; Treatment Outcome