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Is the tracheal index useful for evaluating the thyroid in infants suspected of hypothyroidism?

Nursel Muratoglu Sahin1, Hasibe Gokce Cinar2, Behiye Sarikaya Ozdemir1

  • 1Division of Pediatric Endocrinology, University of Health Sciences, Dr. Sami Ulus Obstetrics and Gynecology, Child Health and Diseases Training and Research Hospital, Ankara, Türkiye.

Journal of Pediatric Endocrinology & Metabolism : JPEM
|December 10, 2025
PubMed

Insights

The tracheal index (TI) is a useful estimate of thyroid size in infants, correlating with thyroid volume (TV). However, its accuracy is limited in preterm infants, those with low birth weight, and cases of thyroid hyperplasia.

Area of Science:

  • Pediatric Endocrinology
  • Neonatal Imaging
  • Thyroid Diagnostics

Background:

  • Assessing thyroid size in infants is challenging due to short necks.
  • The tracheal index (TI) offers an alternative measurement method using transverse dimensions.
  • Previous studies focused on normative TI data in infants.

Purpose of the Study:

  • To evaluate the utility of the tracheal index (TI) in infants suspected of congenital hypothyroidism.
  • To assess the correlation between TI and thyroid volume (TV) in this population.

Main Methods:

  • Eighty infants with elevated TSH levels from newborn screening were included.
  • Thyroid size was assessed using thyroid volume (TV), TV standard deviation score (SDS), and TI.
  • Statistical analysis examined correlations between TI, TV, and TV SDS.

Main Results:

  • TI showed a positive correlation with both TV and TV SDS (r=0.381, p<0.0001; r=0.400, p<0.0001).
  • No correlation was observed between TI and TV in preterm infants (<38 weeks gestation) or those with low birth weight (<2,700g or <-1 SDS BW).
  • The sensitivity and specificity of TI for detecting thyroid hyperplasia were 53.8% and 65.7%, respectively.

Conclusions:

  • TI is useful for estimating thyroid size in both hypothyroid and normal infants.
  • TI's correlation with TV is limited in preterm infants and those with low birth weight.
  • Low sensitivity and specificity indicate limited utility of TI for assessing thyroid hyperplasia in specific infant groups.
Abstract

Keywords:
SGAhypothyroidisminfantnewbornpretermtracheal index

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