Association Between Thyroid Parenchymal Echogenicity and Thyroid Function in Pediatric Population

Abstract

Background: The association between the thyroid echo pattern and thyroid function has an important impact on the diagnosis and treatment of thyroid diseases in children. Objectives: The present study aimed to compare thyroid parenchymal echogenicity with thyroid function tests and evaluate the value of a thyroid ultrasound (US) in predicting thyroid function parameters in the pediatric population. Methods: A total of 434 children (age range: 5 - 18 years; mean age: 13.18 ± 3.42 years) were categorized into two groups based on the thyroid parenchymal appearance on the US as subjects with homogeneous (group 1) and heterogeneous (group 2) echo patterns. Thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), thyroglobulin antibody (Tg-Ab), and thyroperoxidase antibody (TPO-Ab) levels were evaluated and compared between the two groups. Results: The levels of TSH, fT3, fT4, Tg-Ab, and TPO-Ab were significantly different between the two groups (P < 0.0001). All thyroid function tests were within normal ranges in 73.4% (168/229) and 14.6% (30/205) of children with homogeneous and heterogeneous echo patterns, respectively. The homogeneous thyroid gland on the US had 73.8% sensitivity in predicting normal TSH and 100% sensitivity in predicting normal fT3 and fT4. The sensitivity for predicting negative Tg-Ab and TPO-Ab were 78.7 and 85.3%, respectively. Conclusions: The current study compared the homogeneous and heterogeneous thyroid echo patterns with the thyroid function tests in children. The obtained results confirmed the value of the thyroid US in predicting thyroid function in the pediatric population.