The association between thyroid echogenicity and thyroid function in pediatric and adolescent Hashimoto's thyroiditis

Area of Science:

• Pediatric Endocrinology
• Radiology
• Immunology

Background:

• Hashimoto's thyroiditis (HT) is a common autoimmune thyroid disease in children and adolescents.
• Thyroid ultrasonography (US) is a key imaging modality for evaluating thyroid morphology.
• Assessing the relationship between US findings and thyroid function is crucial for disease management.

Purpose of the Study:

• To investigate the association between thyroid echogenicity on US and thyroid function in pediatric and adolescent HT patients.
• To determine if US echogenicity grading can predict thyroid dysfunction severity.

Main Methods:

• Retrospective evaluation of 86 pediatric and adolescent patients diagnosed with HT.
• Correlation analysis between thyroid echogenicity grades (1-4) on US and thyroid function tests (TSH, free T4).
• Assessment of microsomal autoantibody status in relation to US findings and thyroid function.

Main Results:

• A significant positive correlation was observed between increased US echogenicity grade and elevated thyroid-stimulating hormone (TSH) levels (P < .001).
• Conversely, higher US grades were significantly associated with decreased free thyroxine (fT4) levels (P < .001).
• 89.2% of patients with overt hypothyroidism had US grades 3 or 4, while 97.8% of euthyroid or subclinically hypothyroid patients had grades 1 or 2.

Conclusions:

• Thyroid echogenicity on US is a valuable indicator of thyroid function in pediatric and adolescent HT.
• Higher US echogenicity grades correlate with reduced thyroid function and increased likelihood of hypothyroidism in HT patients.
• US grading can aid in assessing disease severity and monitoring progression in young HT patients.