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Sonographic assessment of thyroglossal duct cysts in children
Naoki Kutuya1, Yoshihisa Kurosaki
1Department of Radiology, Juntendo University, School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan. hollyhock22@hotmail.com
Insights
Thyroglossal duct cysts (TDCs) in children typically appear hypoechoic to heterogeneous on ultrasound. Wall thickening and internal septa suggest inflammation, aiding in diagnosis.
Area of Science:
- Pediatric imaging
- Diagnostic ultrasound
- Head and neck pathology
Background:
- Thyroglossal duct cysts (TDCs) are common congenital anomalies.
- Understanding their sonographic features is crucial for accurate diagnosis in children.
- The impact of inflammation on TDC appearance requires further clarification.
Purpose of the Study:
- To define the characteristic sonographic features of pediatric thyroglossal duct cysts (TDCs).
- To assess how inflammation affects the ultrasound appearance of TDCs.
Main Methods:
- Retrospective review of sonograms from 36 children with pathologically confirmed TDCs.
- Evaluation of lesion characteristics including location, shape, echogenicity, septa, wall, and enhancement.
- Specific analysis of sonographic features in 7 inflamed TDC cases.
Main Results:
- TDCs were predominantly midline (77.8%), unilocular (86.1%), and showed posterior enhancement (77.8%).
- Internal echo patterns varied: anechoic (25%), hypoechoic (16.7%), pseudosolid (16.7%), and heterogeneous (41.6%).
- Wall thickening (78%) and internal septa (100%) correlated with inflammation.
Conclusions:
- Pediatric TDCs exhibit a range of echogenicity from hypoechoic to heterogeneous.
- Thickened walls and internal septa are indicators of inflammation in TDCs.
- These sonographic findings aid in differentiating inflamed from non-inflamed TDCs.
Objective:
The purpose of this study was to clarify the sonographic features of thyroglossal duct cysts (TDCs) in children. We also investigated how the presence of inflammation influences the sonographic appearance.
Methods:
We reviewed the sonograms from 36 children (0.5-14 years old) with pathologically proven TDCs. The lesions were evaluated for location, shape, internal echo pattern, internal septa, wall thickness, posterior enhancement, solid components, margins, and fistulas. The sonographic features of 7 lesions that pathologically showed inflammation were also investigated.
Results:
Most TDCs were midline (77.8%), were located at the hyoid bone (44.4%) or were infrahyoid (38.9%), showed posterior enhancement (77.8%), were unilocular (86.1%), lacked internal septa (91.7%), and had a thin wall (75%). None had a solid component. The internal echo patterns were classified into 4 types: anechoic (25%), homogeneously hypoechoic (16.7%), pseudosolid (16.7%), and heterogeneous (41.6%). Inflammation was confirmed in 78% of the lesions with wall thickening and 100% of the lesions with internal septa.
Conclusions:
Most TDCs in children had echogenicity ranging from hypoechoic to heterogeneous. A thick wall and internal septa were considered to correlate with the presence of inflammation but not with the internal echo patterns of TDCs.
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