Purpose or Case Report: Several ultrasound (US) findings are associated with specific thyroid diseases, but in the vast majority of cases, only a few of these findings are seen. The purpose of this poster is to describe the US findings in a variety of clinically/biopsy-proven thyroid diseases and analyze the frequency of such findings in each of the following diseases.
Methods & Materials: We conducted a retrospective chart review on 156 thyroid ultrasounds of pediatric patients (<21 years old) within the past 10 years at a large community-based academic institution. We correlated imaging findings with clinical information, lab data, and pathology findings collected from our electronic medical record.
Results: There are four thyroid pathologies that we report upon: Grave’s Disease, Hashimoto’s Thyroiditis, Papillary Thyroid Carcinoma, and Hurthle Cell Carcinoma. Of the four cases of Grave’s disease, all of them showed diffuse enlargement, coarsened echotexture, and hypervascularity, while half showed a lobulated contour. Of the nine cases of Hashimoto’s Thyroiditis, 77.7% showed heterogeneous echotexture, 44.4% thyromegaly, 33.3% cervical lymphadenopathy, 22.2% thickened isthmus, and 22.2% multiple hypoechoic micronodules. Papillary thyroid carcinoma showed only cystic changes; it did not demonstrate punctate calcifications, ill-defined/irregular margins, or a hypoechoic rim. Hurthle cell carcinoma only showed punctate calcifications, and did not demonstrate cystic changes, ill-defined/irregular margins, or a hypoechoic rim.
Conclusions: Hashimoto’s thyroiditis was the most common disease in our series followed by Grave’s disease. The most prominent finding of Hashimoto’s is heterogeneous echotexture of the gland. Diffuse enlargement, coarsened echotexture, and hypervascularity (thyroid inferno) were seen in all of our Grave’s patient’s. Papillary and Hurthle Cell cancers did not demonstrate the majority of the findings that we typically expect to see, likely due to their small numbers.