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

No abstract available.
Biopsy, Fine-Needle ; Choristoma/*diagnosis/radionuclide imaging/ultrasonography ; Female ; Humans ; Middle Aged ; Thyroglossal Cyst/*diagnosis/radionuclide imaging/ultrasonography ; Thyroid Dysgenesis/*diagnosis/radionuclide imaging/ultrasonography ; Thyroid Nodule/*diagnosis/radionuclide imaging/ultrasonography

PURPOSE: To understand the various clinical and radiological features of ectopic thyroid. MATERIALS AND METHODS: This study involved nine ectopic thyroid cases (M:F=2:7; age range, 2-57 years) confirmed by RI thyroidscan between 1993 and 1997. We analyzed one neck ultrasonogram, five CT scans, three MR images, nine Tc-99mthyroid scans, and classified the ectopic thyroid by the basis of these findings. Hormonal abnormalities andsymptoms were evaluated on the basis of medical records. RESULTS: The status of nine patients was found to beeuthyroid (n=6), hypothyroid (n=2) or hyperthyroid (n=1). Among the nine, the ectopic thyroid was lingual (n=6),sublingual (n=3) or thyroglossal (n=1); one patient had both the lingual and sublingual types. Ectopic thyroid wasseen as a well-defined round mass, homogeneously enhanced on CT scan, homogeneously hyperechogenic onultrasonogram and of intermediate signal intense on MRI. All cases showed ectopic radioactivity uptake on Tc-99mthyroid scan. In eight patients, ectopic thyroid was the only hormone-producing thyroid tissue; one had bothnormal thyroid and ectopic thyroid tissue in a thyroglossal duct cyst. Among the six cases of euthyroidism,ectopic thyroid patients with the lingual type complained of throat discomfort. Those with the sublingual typecomplained of palpable neck mass, and preoperative evaluation of thyroglossal duct cyst showed that this wasectopic thyroid. CONCLUSION: Understanding the various clinical and radiologic features of ectopic thyroid canhelp accurate diagnosis and prevent unnecessary surgery or other procedure.
Diagnosis ; Humans ; Magnetic Resonance Imaging ; Medical Records ; Neck ; Pharynx ; Radioactivity ; Thyroglossal Cyst ; Thyroid Dysgenesis* ; Thyroid Gland ; Tomography, X-Ray Computed ; Ultrasonography ; Unnecessary Procedures

PURPOSE:The project of the neonatal mass screening test for inborn errors of metabolism are just at the beginning in Korea and there was a few reports about the overall incidence and subtypes of congenital hypothyroidism. METHODS:In this study, we analysed the 97 cases of newborns with hyperthyrotropinemia who were detected by neonatal screening test to identify the incidence and early clinical manifestations of each subtypes of congenital hypothyroidism. Thyroid function were measured by thyrotropin(TSH) level, T4, T3, Free T4, Free T3, thyroglobulin, T3 resin uptake, TBII, TBG in serum, thyroid ultrasonography and 99mTc thyroid scan. We reanalysed the thyroid functions 1 week after discontinuance of L-thyroxine treatment for 1 year. RESULTS: 1) The time of neonatal screening test were between 3 and 7 days after birth in 46 cases(47.4%) and 8 and 14 days after birth in 35 cases(36.1%). Two cases (2.1%) were done neonatal screening test at the age of 2 days old. 2) The major cause of thyroid disorders were primary hypothyroidism in 45 cases of the total due to thyroid aplasia(7 cases), thyroid hypoplasia(17 cases), ectopic thyroid gland(12 cases) and dyshormonogenesis(9 cases). Other causes of thyroid disorders were TBG deficiency(11 cases), TBG dysfuction(1 case), transient hyperthyrotropinemia(28 cases) and transient hypothyroidism(12 cases). 3) Serum level of thyrotropin(TSH) at diagnosis were 223.5+/-229.6microU/ml in thyroid aplasia, 41.6+/-42.9microU/ml in thyroid hypoplasia, 52.4+/-55.6microU/ml in ectopic thyroid gland. TSH levels were significantly high in thyroid aplasia. T4 levels in thyroid aplasia are 1.7+/-2.0microg/dl and this is significantly lower than other types of thyroid disorders. T3 levels were within normal range except in thyroid aplasia and TBG deficiency. 4) Prolongation of physiologic jaundice was the most common clinical manifestation(33.3%) in patients with primary hypothyroidism and macroglossia, hypothermia, umbilical hernia and cold skin were the next commom clinical manifestations in order to present. 5) Osseous development was normal in 57 cases(82.6%) out of 69 cases who accomplished roentgenographic examination of knees. Only 12 cases(17.4%) showed retardation of osseous development, but there was no significant differences between types of thyroid disorders. 6) Most of the newborn(93.3%) with primary hypothyroidism started to treatment within 8 weeks of age. 7) Initial dosage of L-thyroxine was 10microg/kg/day and decreased 6 to 12 months after treatment. 8) There was significantly decreased thyroid uptake of 99mTc after 1 year follow-up in 5 cases of dyshormonogenesis. 9) The serum TSH levels returned to normal ranges within 6 month after treatment in transient hypothyroidism and transient hyperthyrotropinemia. CONCLUSIONS:Special attention should be paid to transient hyperthyrotropinemia and transient hypothyroidism because many of the congenital thyroid disorders showed transient type and it is necessary to establish the diagnostic guideline to early detect these transient types of congenital thyroid disorders.
Congenital Hypothyroidism ; Diagnosis ; Follow-Up Studies ; Hernia, Umbilical ; Humans ; Hypothermia ; Hypothyroidism ; Incidence ; Infant, Newborn ; Jaundice ; Knee ; Korea ; Macroglossia ; Mass Screening ; Metabolism, Inborn Errors ; Neonatal Screening* ; Parturition ; Reference Values ; Skin ; Thyroglobulin ; Thyroid Dysgenesis ; Thyroid Gland* ; Thyroxine ; Ultrasonography

No abstract available.
Adult ; Biological Markers/blood ; Female ; Humans ; Mouth Floor ; *Neck/radiography/radionuclide imaging/ultrasonography ; Predictive Value of Tests ; Radiopharmaceuticals/diagnostic use ; Sodium Pertechnetate Tc 99m/diagnostic use ; Thyroid Dysgenesis/blood/*diagnosis/drug therapy ; Thyroid Function Tests ; *Thyroid Gland/drug effects/metabolism/radiography/radionuclide imaging/ultrasonography ; Thyrotropin/blood ; Thyroxine/blood/therapeutic use ; Tomography, X-Ray Computed