title: Diagnostic performance of thyroid ultrasonography screening in pediatric patients with a hypothyroid, hyperthyroid or euthyroid goiter.
abstract: BACKGROUND
  Goiter is frequently the first indicator of thyroid disease in children.
  
  
  OBJECTIVE
  To evaluate the usefulness of ultrasonography (US) in the identification of potential malignant nodules and autoimmune thyroiditis in children with diffuse goiter.
  
  
  METHODS
  This study consisted of 113 patients <20 years with a diffuse goiter who underwent thyroid US. Parenchymal echogenicity and the presence of nodules and abnormal lymph nodes were evaluated on US; if a thyroid nodule was detected, its characteristics were analyzed. The diagnostic accuracy of the US findings in the diagnosis of autoimmune thyroid disease was assessed.
  
  
  RESULTS
  Thyroid nodules were detected on US in 72 of the 113 (63.7%) patients. Of these, 65 (90.3%) had probably benign nodules and 4 (5.6%) patients had nodules suspicious of malignancy. The remaining had indeterminate nodules only. In one child with suspected malignant nodules, papillary thyroid cancer with coexisting autoimmune thyroiditis was confirmed. Hypoechogenicity was visualized in 23 (88.5%) patients with autoimmune thyroiditis and 12 (85.7%) with Graves disease. The sensitivity and specificity of micronodulation for autoimmune thyroiditis were 53.9% and 98.3%, respectively.
  
  
  CONCLUSIONS
  Although the potential for malignant nodules is relatively low in children with diffuse goiter, US can detect focal thyroid disease and characterize the nodules. US thus plays a useful role in excluding autoimmune thyroiditis in this population.
authors: Department of Radiology, Yeouido St. Mary's Hospital, The Catholic University of Korea, 63-10 Yeoudodong-ro, Seoul, South Korea, 150-713.
authors: Soo Jin
authors: SJ
authors: Lee
authors: Department of Radiology, Yeouido St. Mary's Hospital, The Catholic University of Korea, 63-10 Yeoudodong-ro, Seoul, South Korea, 150-713. shlgy@catholic.ac.kr.
authors: Gye-Yeon
authors: GY
authors: Lim
authors: Department of Radiology, Yeouido St. Mary's Hospital, The Catholic University of Korea, 63-10 Yeoudodong-ro, Seoul, South Korea, 150-713.
authors: Jee Young
authors: JY
authors: Kim
authors: Department of Pediatrics, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea.
authors: Min Ho
authors: MH
authors: Chung
mesh_terms: D003937:Diagnosis, Differential; D005260:Female; D006044:Goiter, Nodular / Q000000981:diagnostic imaging*; D006801:Humans; D006980:Hyperthyroidism / Q000000981:diagnostic imaging*; D007037:Hypothyroidism / Q000000981:diagnostic imaging*; D008297:Male; D008403:Mass Screening / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013961:Thyroid Gland / Q000000981:diagnostic imaging*; D013967:Thyroiditis, Autoimmune / Q000000981:diagnostic imaging*; D014463:Ultrasonography / Q000379:methods*
keywords: Autoimmune thyroiditis; Child; Doppler; Goiter; Thyroid gland; Ultrasound