Related Experiment Video
Updated: Apr 5, 2026
Author Spotlight: Integrating Ultrasound Imaging with Biochemical Markers for Thyroid Disease Diagnosis
Published on: February 9, 2024
Diagnostic performance of thyroid ultrasonography screening in pediatric patients with a hypothyroid, hyperthyroid or
Soo Jin Lee1, Gye-Yeon Lim2, Jee Young Kim1
1Department of Radiology, Yeouido St. Mary's Hospital, The Catholic University of Korea, 63-10 Yeoudodong-ro, Seoul, South Korea, 150-713.
Insights
Ultrasonography (US) helps identify thyroid nodules in children with goiter, with most being benign. This imaging technique is valuable for characterizing nodules and aiding in the exclusion of autoimmune thyroiditis.
Area of Science:
- Pediatric Endocrinology
- Diagnostic Imaging
- Oncology
Background:
- Goiter is a common initial sign of thyroid disease in pediatric patients.
- Early detection and characterization of thyroid abnormalities are crucial for appropriate management.
Purpose of the Study:
- To assess the utility of ultrasonography (US) in identifying potentially malignant nodules and autoimmune thyroiditis in children presenting with diffuse goiter.
- To evaluate the diagnostic accuracy of US findings for autoimmune thyroid disease.
Main Methods:
- A cohort of 113 pediatric patients (<20 years) with diffuse goiter underwent thyroid ultrasonography.
- US evaluated parenchymal echogenicity, nodule presence and characteristics, and lymph node status.
- Diagnostic accuracy of US for autoimmune thyroid disease was determined.
Main Results:
- Thyroid nodules were identified in 63.7% of patients; 90.3% were likely benign, and 5.6% were suspicious for malignancy.
- Papillary thyroid cancer with coexisting autoimmune thyroiditis was confirmed in one child with suspicious nodules.
- Hypoechogenicity was observed in 88.5% of patients with autoimmune thyroiditis and 85.7% with Graves disease; micronodulation sensitivity/specificity for autoimmune thyroiditis was 53.9%/98.3%.
Conclusions:
- Ultrasonography is effective in detecting and characterizing thyroid nodules in children with diffuse goiter, despite a low risk of malignancy.
- US plays a significant role in ruling out autoimmune thyroiditis in this pediatric population.
Background:
Goiter is frequently the first indicator of thyroid disease in children.
Objective:
To evaluate the usefulness of ultrasonography (US) in the identification of potential malignant nodules and autoimmune thyroiditis in children with diffuse goiter.
Materials And Methods:
This study consisted of 113 patients <20 years with a diffuse goiter who underwent thyroid US. Parenchymal echogenicity and the presence of nodules and abnormal lymph nodes were evaluated on US; if a thyroid nodule was detected, its characteristics were analyzed. The diagnostic accuracy of the US findings in the diagnosis of autoimmune thyroid disease was assessed.
Results:
Thyroid nodules were detected on US in 72 of the 113 (63.7%) patients. Of these, 65 (90.3%) had probably benign nodules and 4 (5.6%) patients had nodules suspicious of malignancy. The remaining had indeterminate nodules only. In one child with suspected malignant nodules, papillary thyroid cancer with coexisting autoimmune thyroiditis was confirmed. Hypoechogenicity was visualized in 23 (88.5%) patients with autoimmune thyroiditis and 12 (85.7%) with Graves disease. The sensitivity and specificity of micronodulation for autoimmune thyroiditis were 53.9% and 98.3%, respectively.
Conclusion:
Although the potential for malignant nodules is relatively low in children with diffuse goiter, US can detect focal thyroid disease and characterize the nodules. US thus plays a useful role in excluding autoimmune thyroiditis in this population.
Related Concept Videos
01:17Ultrasonography
During an ultrasonography procedure, a handheld device called...
01:24Imaging Studies II: Ultrasonography
01:25Ultrasound II: Endoscopic Ultrasound and FibroScan
Endoscopic Ultrasound (EUS):
01:23The Thyroid Gland
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...