Elsevier

The Journal of Pediatrics

Volume 143, Issue 6, December 2003, Pages 759-764
The Journal of Pediatrics

Thyroid abnormalities by ultrasonography in neonates with congenital hypothyroidism

https://doi.org/10.1067/S0022-3476(03)00537-7Get rights and content

Abstract

Objectives

To investigate the usefulness of thyroid ultrasonography for neonates with congenital hypothyroidism.

Study design

Patients (n = 66) were evaluated by ultrasonography at age 15.2±12 days.

Results

Thyroid scanning was more sensitive for the identification of ectopic tissue as ultrasonography showed ectopic thyroid tissue in only 9 of 42 cases. In cases for which no iodine uptake was demonstrated by thyroid scanning (n = 12), ultrasonography showed normally located thyroid tissue in 2 patients. Therefore, on the basis of both thyroid scanning and ultrasonography, 10 cases were classified as athyreosis, and 14 cases were classified as showing normal location of the thyroid gland. Among the latter 14 cases, 5 showed a developmental abnormality. Ultrasonography also revealed additional phenotypic abnormalities in patients with thyroid dysgenesis, with cysts (n = 6) and thymus tissue (n = 4) within the empty thyroid area, which are novel observations in these patients.

Conclusions

Ultrasonography may reveal additional findings with regard to those obtained by scintigraphy such as information regarding the anatomy of the thyroid gland, presence of cysts, and presence of additional thymic tissue within the empty thyroid area.

Section snippets

Patients and methods

Of the 286,863 infants screened in our center between January 1, 1996 and March 31, 2002, 86 infants were detected as having elevated neonatal thyrotropin (TSH) values. Six infants had transient TSH increases, and 80 infants had hypothyroidism, giving an incidence of 1/3586, similar to that reported elsewhere.1 Only patients evaluated at the Robert Debré Hospital (n = 69) and who were examined by both thyroid scanning and ultrasonography (n = 66) were included in the study.

The diagnosis of

Results

The characteristics of the patients at the time of the study with respect to the etiologic diagnoses assessed by both thyroid scanning and ultrasonography findings are shown in the Table. Among the 66 patients with CH, 42 of them (64% of cases) were diagnosed as having ectopic thyroid tissue. As expected, thyroid scanning proved more sensitive to the identification of ectopic tissue. Thyroid ultrasonography showed ectopic tissue in 9 of 42 cases (21% sensitivity). This ectopic thyroid tissue

Discussion

We demonstrate that ultrasonography is useful to identify normally located thyroid gland and to delineate its anatomy. One patient showed a thyroid developmental anomaly with hemiplasia of the left lobe. Thyroid hemiagenesis is a well known but rare congenital anomaly either with or, more frequently, without hypothyroidism and with a higher incidence of agenesis of the left lobe.12., 13., 14. Thus, ultrasonography is superior to scintigraphy in the assessment of thyroid morphology in normal

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