Chinese Journal of Evidence-Based Pediatrics ›› 2021, Vol. 16 ›› Issue (4): 291-295.

• Original Papers • Previous Articles     Next Articles

The thyroid ultrasonography screening in children based on growth development, assessment and intervention:A cross-sectional study

LI Yang1,3, WANG Zhengrong2, GUO Jiayun1, ZHANG Yong2, LI Hui1,3   

  1. 1 Department of Growth and Development, Capital Institute of Pediatrics, Beijing 100020, China;2 Department of Ultrasound, the Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing 100020, China;3 Graduate school,Peking Union Medical college,BeiJing 100050,China
  • Received:2021-02-25 Revised:2021-04-09 Online:2021-08-25 Published:2021-08-25
  • Contact: LI Hui; WANG Zhengrong

Abstract: Background: The detection rate of polycystic thyroid disease (PCTD) by thyroid ultrasonography in healthy children is high, but the incidence of PCTD and related studies are few, and the other group of PCTD deserves attention. Objective: Thyroid ultrasonography was performed to screen for PCTD in children who needed intervention after the assessment of growth and development . Design: Cross-sectional survey. Methods: We included the cases whose complains were relatively short stature, decreased height growth rate or puberty development assessment, with normal FT3 and FT4 and negative antibodies(Tg-Ab,TR-Ab and TPO-Ab), requiring drug intervention and thyroid ultrasonography after clinical evaluation. Medical records and ultrasound results on the day of visit and other were collected. According to the ultrasound image observation and analysis indicators, the patients were divided into normal group, PCTD group (≥4 thyroid cysts, negative tests for thyroid autoantibody,no evidence for thyroid diseases and abnormal thyroid structure) and other group (solid thyroid nodules, multiple cysts with solid nodules and the number of cysts less than 4). Main outcome measures: Detection rate of PCTD. ResultsA total of 572 children met inclusion and exclusion criteria, aged from 3.0 to 17.0 (9.5±2.74) years, including 259 males and 313 females. There were 364 cases in normal group, 161 cases in PCTD group (28.2%), and 47 cases in follow-up group. HtSDS<-2 was found in the normal group at 3 to 5 years old and the PCTD group at 4 to 5 years old. WtSDS<-2 was found in the PCTD group at 5 years old. The standard deviation of height and weight in other age groups was in the normal range, but the HtSDS and WtSDS ranged from -2 to 0 . The detection rate of boys and girls with PCTD was 23.6% (61/259) and 31.9% (100/313), respectively . The rate of PCTD was significantly increased (>27.0%) for 7 years or older. There were 11 cases of goiter in PCTD group (7.1%) and 14 cases of goiter in normal group (4.6%).All cysts in PCTD had regular margins and cysts were distributed diffusely in bilobal and isthmus in 28 cases, 113 cases in bilobal, 17 cases in right lobe and 3 in left lobe. 85.7% of PCTD cysts showed spotty strong echo with comet tail sign, and 74.5% of thyroid parenchyma echo was uniform. Fourteen cases in the normal group and 9 cases in the PCTD group with TSH > 5 mIU·L-1 were in subclinical hypothyroidism. Conclusion: Pediatric PCTD is not a rare condition, especially higher in children after 7 years of age. The detection rate of PCTD in girls is higher than that in boys. The follicular cysts were mostly located in bilateral lobes, with spotty strong echo and comet tail sign. The cyst size was mostly less than 5 mm.

Key words: Polycystic thyroid disease, Children, Thyroid, Ultrasonography