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Thyroid scintigraphy in children with hypothyroidism: a five-year experience
P Pusuwan1, S Likitmaskul, S Wacharasindhu
1Department of Radiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Insights
Thyroid scintigraphy is crucial for diagnosing cretinism in children. This imaging technique helps identify thyroid gland presence, absence, or abnormal location, aiding genetic and prognostic counseling.
Area of Science:
- Pediatric Endocrinology
- Nuclear Medicine
- Medical Imaging
Background:
- Thyroid scintigraphy is vital for diagnosing cretinism.
- Accurate diagnosis impacts genetic counseling and sibling screening.
- Understanding thyroid tissue presence is key for patient management.
Purpose of the Study:
- To evaluate the utility of technetium-99m-pertechnetate thyroid scintigraphy in children with cretinism.
- To categorize thyroid gland localization based on scintigraphic findings.
- To assess the role of the perchlorate discharge test in identifying organification defects.
Main Methods:
- Technetium-99m-pertechnetate thyroid scintigraphy performed on 27 children with cretinism.
- Classification of thyroid localization into athyrotic, ectopic, or normal position.
- Perchlorate discharge test conducted on a subset of patients with normally positioned glands.
Main Results:
- 48.1% of children were athyrotic (lacked thyroid tissue).
- 11.1% had an ectopic thyroid (abnormally located).
- 40.8% had a normally positioned thyroid gland, with 8 positive perchlorate discharge tests indicating organification defects.
Conclusions:
- Thyroid scintigraphy effectively determines thyroid tissue presence and location in pediatric cretinism.
- The perchlorate discharge test aids in diagnosing organification defects.
- These diagnostic tools are valuable for diagnosis, follow-up, and prognosis in children with cretinism.
Abstract:
The presence or absence of thyroid glandular tissue demonstrated by thyroid scintigraphy is important for genetic and prognostic counseling and for acceleration of diagnosis in other affected siblings. Technetium-99m-pertechnetate thyroid scintigraphy was performed on 27 children with cretinism at the Division of Nuclear Medicine, Faculty of Medicine Siriraj Hospital during the 5-year period from June 1991. Based on scintigraphic findings, three main groups of thyroid localization were seen. Thirteen (48.1%) were athyrotic while 3 (11.1%) had an ectopic thyroid and 11 (40.8%) had gland in normal position. Perchlorate discharge test was performed in 8 children of the last group and the results were positive indicating an organification defect. Thyroid scintigraphy and perchlorate discharge test provided the useful information for diagnosis, follow-up, and prognosis in children with cretinism.