Doppler evaluation of pediatric goiter: effect of mandatory iodination

Area of Science:

• Pediatric Endocrinology
• Nutritional Science
• Medical Imaging

Background:

• Iodine deficiency disorders (IDD) remain a global health concern, particularly in endemic regions.
• Goiter, an enlargement of the thyroid gland, is a common manifestation of iodine deficiency.
• Thyroid hemodynamics, assessed via Doppler ultrasonography, can reflect thyroid function and metabolic status.

Purpose of the Study:

• To evaluate the impact of iodized salt consumption on thyroid hemodynamics in children with goiter.
• To assess changes in thyroid blood flow parameters (Peak Systolic Velocity and Resistance Index) after 3 years of iodized salt intervention in an iodine-deficient region.

Main Methods:

• A cohort of 66 children (7-12 years) with goiter was studied, divided into groups based on thyroid volume and urinary iodine levels.
• Thyroid duplex sonography was performed to measure Peak Systolic Velocity (PSV) and Resistance Index (RI) in the inferior thyroid artery.
• Comparison was made between children with low urinary iodine and normal thyroid volume (Group 1), those with adequate urinary iodine and enlarged thyroids (Group 2), and a control group.

Main Results:

• Children with goiter and low urinary iodine (Group 1) exhibited significantly higher PSV compared to Group 2 and controls.
• No significant difference in PSV was observed between Group 2 and the control group.
• Both Group 1 and Group 2 showed significantly lower RI than the control group, indicating altered vascular resistance.

Conclusions:

• Iodine supplementation through iodized salt positively influences thyroid hemodynamics in children with goiter.
• The observed hemodynamic changes suggest that iodination affects thyroid vascularity even before complete normalization of thyroid size.
• These findings support the effectiveness of iodized salt in managing iodine deficiency disorders and their associated thyroid changes.