Sonographic evaluation of the thyroid size in neonates

Freire, Ronald; Monte, Osmar; Tomimori, Eduardo; Catarino, Regina Maria; Sterza, Thais; Rocha, Thatyana; Pereira, Katia Cristine Carvalho; Mattos, Hortensio Simões de; Fagundes, Leonardo Barros; Liberato, Marcelo Martins; Santos, Luiz Wagner Rodrigues dos; Pereira, Adeberto; Cintra, Thassila Cáccia Feragi; Hegner, Christina; Lube, Daniela; Murad, Mylene

doi:10.1002/jcu.22244

Cited by 10 publications

(9 citation statements)

References 24 publications

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“…It is a noninvasive nonirradiating costeffective imaging technique, but highly observer dependent. Thyroid volume in newborns varies from 0.84 -0.38 to 1.62 -0.41 mL (60-62), without significant changes during the first 3 weeks of life (63). Thyroid size can be influenced by (long-term) TSH suppression during LT4 treatment.…”

Section: Discussionmentioning

confidence: 99%

Congenital Hypothyroidism: A 2020–2021 Consensus Guidelines Update—An ENDO-European Reference Network Initiative Endorsed by the European Society for Pediatric Endocrinology and the European Society for Endocrinology

Trotsenburg

Stoupa

Léger

et al. 2021

Thyroid

291

254

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Background: An ENDO-European Reference Network (ERN) initiative was launched that was endorsed by the European Society for Pediatric Endocrinology and the European Society for Endocrinology with 22 participants from the ENDO-ERN and the two societies. The aim was to update the practice guidelines for the diagnosis and management of congenital hypothyroidism (CH). A systematic literature search was conducted to identify key articles on neonatal screening, diagnosis, and management of primary and central CH. The evidence-based guidelines were graded with the Grading of Recommendations, Assessment, Development and Evaluation system, describing both the strength of recommendations and the quality of evidence. In the absence of sufficient evidence, conclusions were based on expert opinion. Summary: The recommendations include the various neonatal screening approaches for CH as well as the etiology (also genetics), diagnostics, treatment, and prognosis of both primary and central CH. When CH is diagnosed, the expert panel recommends the immediate start of correctly dosed levothyroxine treatment and frequent follow-up including laboratory testing to keep thyroid hormone levels in their target ranges, timely assessment of the need to continue treatment, attention for neurodevelopment and neurosensory functions, and, if necessary, consulting other health professionals, and education of the child and family about CH. Harmonization of diagnostics, treatment, and follow-up will optimize patient outcomes. Lastly, all individuals with CH are entitled to a well-planned transition of care from pediatrics to adult medicine. Conclusions: This consensus guidelines update should be used to further optimize detection, diagnosis, treatment, and follow-up of children with all forms of CH in the light of the most recent evidence. It should be helpful in convincing health authorities of the benefits of neonatal screening for CH. Further epidemiological and experimental studies are needed to understand the increased incidence of this condition.

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Section: Discussionmentioning

confidence: 99%

Congenital Hypothyroidism: A 2020–2021 Consensus Guidelines Update—An ENDO-European Reference Network Initiative Endorsed by the European Society for Pediatric Endocrinology and the European Society for Endocrinology

Trotsenburg

Stoupa

Léger

et al. 2021

Thyroid

291

254

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“…In an extremely preterm age group, delivered at less than 28 weeks of gestation, an ultrasound study showed no association between mean thyroid volume and thyroid function or between mean thyroid volume and BW 6 . Conversely, a weak correlation exists between thyroid volume and thyroid function in full‐term infants 18 . The distribution of thyroid volumes may have become relatively wide due to the inclusion of both term and preterm infants in our cohort.…”

Section: Discussionmentioning

confidence: 71%

“…The thyroid gland is part of the HPT axis, but the intensity and volume of thyroid gland on MRI have not been evaluated in detail using neonatal MRI, although the volume has been evaluated on ultrasound by a simple estimation method 6,18 . We hypothesized that the intensity and volume of the pituitary and thyroid glands in neonates may be associated with each other.…”

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confidence: 99%

Signal Intensity and Volume of Pituitary and Thyroid Glands in Preterm and Term Infants

Otani

Fushimi

Iwanaga

et al. 2020

Magnetic Resonance Imaging

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Background Hypothalamic–pituitary–thyroid (HPT) maturation has not been extensively evaluated using neonatal MRI, even though both structures are visualized on MRI. Hypothesis That signal intensity and volume of pituitary and thyroid (T) glands on MRI in neonates may be interrelated. Study Type Retrospective. Subjects In all, 102 participants. Field Strength/Sequence 3.0T, T1‐weighted pointwise encoding time reduction with radial acquisition (PETRA). Assessment The volume of interest of the anterior pituitary (AP), posterior pituitary (PP), and T on MRI were defined on T1‐PETRA by two radiologists, and volumes of AP (AP_vol) and thyroid (T_vol) were calculated. Gestational age (GA), chronological age (CA), GA+CA, birth weight (BW), and thyroid function were recorded. Mean and maximum signal intensities of AP, PP, and T were normalized using signals from the pons and spinal cord as follows: signal ratio of anterior pituitary/pons (AP/pons), signal ratio of posterior pituitary/pons (PP/pons), and signal ratio of thyroid/cord (T/cord) T/cord, respectively. Statistical Tests Correlations between signal intensity and volume measures and GA, CA, GA+CA, and BW were assessed using Pearson's correlation coefficient or Spearman's rank correlation coefficient. Thyroid function analysis and Tmean/cord, Tmax/cord, and T_vol were evaluated using the Steel–Dwass test. Results APmean/pons correlated positively with GA (ρ = 0.62, P < 0.001) and BW (ρ = 0.74, P < 0.001), and negatively with CA (ρ = −0.86, P < 0.001) and GA+CA (ρ = −0.46, P < 0.001). PPmean/pons correlated positively with GA (ρ = 0.49, P < 0.001) and BW (ρ = 0.63, P < 0.001), and negatively with CA (ρ = −0.70, P < 0.001) and GA+CA (r = −0.38, P < 0.001). Tmean/cord correlated positively with GA (ρ = 0.48, P < 0.001) and BW (ρ = 0.55, P < 0.001), and negatively with CA (ρ = −0.59, P < 0.001) and GA+CA (ρ = −0.22, P = 0.03). AP_vol correlated positively with GA (ρ = 0.68, P < 0.001) and BW (ρ = 0.73, P < 0.001), and negatively with CA (ρ = −0.72, P < 0.001). T_vol correlated positively with GA (ρ = 0.50, P < 0.001) and BW (ρ = 0.61, P < 0.001), and negatively with CA (ρ = −0.54, P < 0.001). APmean/pons correlated positively with Tmean/cord (ρ = 0.61, P < 0.001). Data Conclusion Signal and volume of pituitary and thyroid glands correlated positively with GA and BW, and negatively with CA in neonates. Level of Evidence 4 Technical Efficacy Stage 5

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“…According to the morphological findings, the DFE was classified as regular or fragmented (ie, with dysgenesis). Thyroid size was assessed with the Th/Tr ratio (Yasumoto ratio), with normal values ranging from 1.7 to 2.9 13,14 …”

Section: Methodsmentioning

confidence: 99%

Sonography of the distal femoral epiphysis in the etiological diagnosis of congenital hypothyroidism

Freire

Becalli

Murad

et al. 2020

J of Clinical Ultrasound

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The etiology of congenital hypothyroidism (CH) is often difficult to identify, owing mainly to limitations in currently available diagnostic tests. Characteristics of the distal femoral epiphyseal (DFE) ossification center may provide important information and help identify some causes of CH. We analyzed the contribution of DFE ultrasonography in the investigation of 11 young infants with positive screening for CH. DFE ultrasonography emerged as a simple test that helped indicate the period of onset of CH and, when associated with clinical history, hormone levels, and thyroid ultrasonography, contributed to suggest the etiology of CH.

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Sonographic evaluation of the thyroid size in neonates

Cited by 10 publications

References 24 publications

Congenital Hypothyroidism: A 2020–2021 Consensus Guidelines Update—An ENDO-European Reference Network Initiative Endorsed by the European Society for Pediatric Endocrinology and the European Society for Endocrinology

Congenital Hypothyroidism: A 2020–2021 Consensus Guidelines Update—An ENDO-European Reference Network Initiative Endorsed by the European Society for Pediatric Endocrinology and the European Society for Endocrinology

Signal Intensity and Volume of Pituitary and Thyroid Glands in Preterm and Term Infants

Sonography of the distal femoral epiphysis in the etiological diagnosis of congenital hypothyroidism

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