Pediatric thyroid ultrasound: a radiologist's checklist

Area of Science:

• Pediatric Endocrinology
• Diagnostic Imaging
• Radiology

Background:

• Ultrasonography (US) is the primary imaging modality for pediatric thyroid evaluation.
• Congenital hypothyroidism, goiter, and autoimmune diseases are common pediatric thyroid conditions.
• Thyroid US is crucial for diagnosing various pediatric thyroid pathologies.

Purpose of the Study:

• To outline key sonographic findings in pediatric thyroid evaluations.
• To propose a standard checklist for performing and interpreting thyroid US in neonates and children.
• To emphasize differences in nodule evaluation between pediatric and adult populations.

Main Methods:

• Review of ultrasonographic findings in pediatric thyroid disease.
• Comparison of diagnostic considerations in newborns versus older children.
• Analysis of nodule characteristics and malignancy risk in pediatric thyroid cancer.

Main Results:

• Ultrasonography aids in diagnosing congenital hypothyroidism, goiter, and diffuse/solid thyroid diseases.
• Nodules in children have a higher malignancy likelihood, warranting a lower threshold for biopsy.
• Adult nodule classification systems are insufficient for pediatric thyroid nodules.

Conclusions:

• Ultrasonography is essential for pediatric thyroid assessment, complemented by other tests.
• A standardized approach and checklist are recommended for pediatric thyroid US.
• Early biopsy and lower size thresholds for nodules in children are crucial due to increased malignancy risk.