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Imaging the thyroid in children.

Jérôme Clerc1

  • 1Université Paris Descartes and Assistance Publique-Hôpitaux de Paris, Department of Nuclear Medicine, Cochin Hospital, 27 rue du Faubourg Saint Jacques, 75679 Paris Cedex 14, France.

Best Practice & Research. Clinical Endocrinology & Metabolism
|March 18, 2014
PubMed
Summary
This summary is machine-generated.

Color Doppler Ultrasound and Thyroid Scanning improve congenital hypothyroidism diagnosis. Dual imaging with Iodine-123 is recommended over Technetium-99m for better accuracy and safety.

Keywords:
color doppler ultrasoundsiodine 123 congenital hypothyroidismthyroid autonomythyroid nodulethyroid scintigraphythyrotoxicosis

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Area of Science:

  • Nuclear medicine
  • Radiology
  • Pediatric endocrinology

Background:

  • Recent advancements in Color Doppler Ultrasound (CDU) and Thyroid Scanning (TS) enhance diagnostic capabilities.
  • Diagnosing congenital hypothyroidism (CH) subtypes benefits significantly from dual imaging techniques.

Purpose of the Study:

  • To evaluate the effectiveness of dual imaging modalities, specifically CDU and TS, in diagnosing congenital hypothyroidism.
  • To compare the utility of Iodine-123 ((123)I) versus Technetium-99m ((99m)Tc) in thyroid scintigraphy for CH.
  • To present imaging patterns associated with CH etiologies and discuss the role of CDU in nodule assessment.

Main Methods:

  • Utilized Color Doppler Ultrasound (CDU) and Thyroid Scanning (TS) with dual imaging.
  • Compared diagnostic performance and dosimetric characteristics of (123)I and (99m)Tc isotopes.
  • Analyzed imaging patterns for thyroid dysgenesis and dyshormonogenesis.
  • Assessed CDU for thyroid autoimmunity, thyrotoxicosis, and autonomy, often in conjunction with (123)I-TS.
  • Introduced the TIRADS scoring system for suspicious thyroid nodules.

Main Results:

  • Dual imaging is more informative than single scanning for congenital hypothyroidism diagnosis.
  • (123)I is more advisable than (99m)Tc for CH diagnosis due to better etiological identification and dosimetry.
  • Detailed dual imaging patterns were presented for thyroid dysgenesis (75%) and dyshormonogenesis (20%).
  • CDU aids in assessing thyroid autoimmunity, thyrotoxicosis, and autonomy, often requiring quantified (123)I-TS.
  • CDU is valuable for evaluating suspicious nodules, with the new TIRADS scoring system presented.

Conclusions:

  • Dual imaging with CDU and TS, particularly using (123)I, offers superior diagnostic accuracy for congenital hypothyroidism.
  • (123)I demonstrates advantages over (99m)Tc in identifying CH causes and radiation safety.
  • CDU plays a crucial role in assessing various thyroid conditions and suspicious nodules, enhanced by the TIRADS system.