Scintigraphic imaging of paediatric thyroid dysfunction

Area of Science:

• Pediatric Endocrinology
• Diagnostic Imaging
• Nuclear Medicine

Background:

• Congenital hypothyroidism (CH) requires precise etiological diagnosis for genetic counseling and management.
• CH arises from thyroid dysgenesis (ectopia, hypoplasia, athyrosis) or eutopic gland issues (transient or dyshormonogenesis).
• Accurate imaging is vital for differentiating CH causes in pediatric patients.

Purpose of the Study:

• To review the role and techniques of thyroid imaging in pediatric thyroid dysfunction.
• To highlight the diagnostic utility of thyroid scintigraphy (TS) and color Doppler ultrasound (CDU).
• To present imaging findings for common pediatric thyroid disorders.

Main Methods:

• Thyroid scintigraphy (TS) using 99mTcO4 or 123I to detect ectopic thyroid tissue.
• 123I uptake measurements before and after perchlorate administration to assess organification.
• Color Doppler ultrasound (CDU) for evaluating thyroid volume, nodules, and vascularization.

Main Results:

• TS effectively identifies ectopic thyroid tissue, the most frequent CH cause.
• 123I scintigraphy offers enhanced accuracy in etiological classification compared to 99mTcO4.
• CDU provides valuable assessment of thyroid size, nodules, and vascularity across all pediatric ages.

Conclusions:

• Thyroid imaging, including TS and CDU, is safe and clinically essential for diagnosing pediatric thyroid dysfunction.
• Imaging modalities precisely characterize CH etiology, guiding genetic counseling and treatment strategies.
• These techniques are instrumental in managing various pediatric thyroid conditions.