Advanced Biomedical Research

Ultrasonographic evaluation of the thyroid gland volume among 8-15-year-old children in Isfahan, Iran

Authors

1 Department of Radiology, Endocrinology and Metabolic Research Center, Isfahan, Iran

2 Department of Pediatrics, Endocrinology and Metabolic Research Center, Isfahan, Iran

3 Department of emergency Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Local reference data are needed in the screening of children for thyroid enlargement. We determined the thyroid gland volume using the ultrasonography (US) in schoolchildren of Isfahan, Iran.
Materials and Methods: A total of 360 schoolchildren (59% girls) aged 8-15 years who met the study criteria were entered the study. Clinical grading of goiter was performed by an endocrinologist according to the World Health Organization (WHO) classification. Then, a single expert radiologist performed thyroid volume measurement using a portable ultrasound device. Urinary iodine (UI) concentration was checked in 36 randomly selected cases.
Results: On physical examination, 327 (91%), 32 (8.8%) and 1 (0.2%) subjects were classified as normal, borderline and goiter Grade 2. Mean thyroid volume measured by US was 1.46 ± 0.70 ml. Thyroid volume in boys was significantly higher than girls (1.58 ± 0.67 ml vs. 1.38 ± 0.71 ml; P = 0.009). Thyroid volume was positively correlated with the clinical grade of the goiter (r = 0.30, P < 0.001) and with age (r = 0.25, P < 0.001). Both median and 95 th percentile of thyroid volume of our subjects was lower than the reference values reported by WHO. Median of UI was 16.90 μg/dl. UI was not correlated with thyroid volume (r = 0.12, P = 0.46).
Conclusion: The thyroid size in Isfahanian schoolchildren is lower than the reference values reported by WHO. These data could be used in determining local reference in the screening of children for thyroid enlargement.

Keywords

1. Kim BK, Choi YS, Oak CH, Park YH, Kim JH, Park DJ, et al. Determination of thyroid volume by ultrasonography among schoolchildren in Philippines. Int J Endocrinol 2012;2012:387971.  Back to cited text no. 1
[PUBMED]    
2. Xu F, Sullivan K, Houston R, Zhao J, May W, Maberly G. Thyroid volumes in US and Bangladeshi schoolchildren: Comparison with European schoolchildren. Eur J Endocrinol 1999;140:498-504.  Back to cited text no. 2
[PUBMED]    
3. Siavash Dastjerdi M, Hashemipour M, Rezvanian H, Kazemi F, Najafian A, Mohammady M, et al. Iron deficiency in goitrous schoolchildren of Semirom, Iran. Horm Res 2006;66:45-50.  Back to cited text no. 3
[PUBMED]    
4. Hess SY, Zimmermann MB. Thyroid volumes in a national sample of iodine-sufficient Swiss school children: Comparison with the World Health Organization/International Council for the control of iodine deficiency disorders normative thyroid volume criteria. Eur J Endocrinol 2000;142:599-603.  Back to cited text no. 4
[PUBMED]    
5. Ying M, Sin MH, Pang SF. Sonographic measurement of thyroid gland volume: A comparison of 2D and 3D ultrasound. Radiography 2005;11:242-8.  Back to cited text no. 5
    
6. Recommended normative values for thyroid volume in children aged 6-15 years. World Health Organization & International Council for Control of Iodine Deficiency Disorders. Bull World Health Organ 1997;75:95-7.  Back to cited text no. 6
[PUBMED]    
7. Berghout A, Wiersinga WM, Smits NJ, Touber JL. Determinants of thyroid volume as measured by ultrasonography in healthy adults in a non-iodine deficient area. Clin Endocrinol (Oxf) 1987;26:273-80.  Back to cited text no. 7
[PUBMED]    
8. Hegedüs L, Perrild H, Poulsen LR, Andersen JR, Holm B, Schnohr P, et al. The determination of thyroid volume by ultrasound and its relationship to body weight, age, and sex in normal subjects. J Clin Endocrinol Metab 1983;56:260-3.  Back to cited text no. 8
    
9. Rasmussen SN, Hjorth L. Determination of thyroid volume by ultrasonic scanning. J Clin Ultrasound 1974;2:143-7.  Back to cited text no. 9
[PUBMED]    
10. Wiersinga WM, Podoba J, Srbecky M, van Vessem M, van Beeren HC, Platvoet-Ter Schiphorst MC. A survey of iodine intake and thyroid volume in Dutch schoolchildren: Reference values in an iodine-sufficient area and the effect of puberty. Eur J Endocrinol 2001;144:595-603.  Back to cited text no. 10
[PUBMED]    
11. Foo LC, Zulfiqar A, Nafikudin M, Fadzil MT, Asmah AS. Local versus WHO/International council for control of iodine deficiency disorders-recommended thyroid volume reference in the assessment of iodine deficiency disorders. Eur J Endocrinol 1999;140:491-7.  Back to cited text no. 11
    
12. Azizi F, Delshad H, Mehrabi Y. Thyroid volumes in schoolchildren of Tehran: Comparison with European schoolchildren. J Endocrinol Invest 2001;24:756-62.  Back to cited text no. 12
[PUBMED]    
13. World Health Organization. United Nations Children's Fund and International Council for the Control of Iodine Deficiency Disorders. Assessment of Iodine Deficiency Disorders and Monitoring Their Elimination, WHO/NHD/01.1. Geneva: WHO; 2001.  Back to cited text no. 13
    
14. Brunn J, Block U, Ruf G, Bos I, Kunze WP, Scriba PC. Volumetric analysis of thyroid lobes by real-time ultrasound (author's transl). Dtsch Med Wochenschr 1981;106:1338-40.  Back to cited text no. 14
[PUBMED]    
15. Aminorroaya A, Amini M, Hovsepian S. Prevalence of goitre in Isfahan, Iran, fifteen years after initiation of universal salt iodization. J Health Popul Nutr 2010;28:351-8.  Back to cited text no. 15
[PUBMED]    
16. Keshteli AH, Hashemipour M, Siavash M, Kelishadi R, Amini M. High prevalence of goiter in schoolchildren in Isfahan; zinc deficiency does not play a role. Endokrynol Pol 2010;61:287-90.  Back to cited text no. 16
[PUBMED]    
17. Marwaha RK, Tandon N, Ashraf GM, Ganguly SK, Batra A, Aggarwal R, et al. Ultrasound evaluation of thyroid size: A large nationwide study of schoolchildren in India. Natl Med J India 2008;21:69-74.  Back to cited text no. 17
[PUBMED]    
18. Delange F, Benker G, Caron P, Eber O, Ott W, Peter F, et al. Thyroid volume and urinary iodine in European schoolchildren: Standardization of values for assessment of iodine deficiency. Eur J Endocrinol 1997;136:180-7.  Back to cited text no. 18
[PUBMED]    
19. Knudsen N, Bols B, Bülow I, Jørgensen T, Perrild H, Ovesen L, et al. Validation of ultrasonography of the thyroid gland for epidemiological purposes. Thyroid 1999;9:1069-74.  Back to cited text no. 19
    
20. Vitti P, Martino E, Aghini-Lombardi F, Rago T, Antonangeli L, Maccherini D, et al. Thyroid volume measurement by ultrasound in children as a tool for the assessment of mild iodine deficiency. J Clin Endocrinol Metab 1994;79:600-3.  Back to cited text no. 20
[PUBMED]    
21. Zimmermann MB, Hess SY, Molinari L, De Benoist B, Delange F, Braverman LE, et al. New reference values for thyroid volume by ultrasound in iodine-sufficient schoolchildren: A World Health Organization/Nutrition for Health and Development Iodine Deficiency Study Group Report. Am J Clin Nutr 2004;79:231-7.  Back to cited text no. 21
    
22. Azizi F, Mehran L, Sheikholeslam R, Ordookhani A, Naghavi M, Hedayati M, et al. Sustainability of a well-monitored salt iodization program in Iran: Marked reduction in goiter prevalence and eventual normalization of urinary iodine concentrations without alteration in iodine content of salt. J Endocrinol Invest 2008;31:422-31.  Back to cited text no. 22
    
23. Busnardo B, Nacamulli D, Frigato F, Vianello-Dri A, De Vido D, Mian C, et al. Normal values for thyroid ultrasonography, goiter prevalence and urinary iodine concentration in schoolchildren of the Veneto Region, Italy. J Endocrinol Invest 2003;26:991-6.  Back to cited text no. 23
[PUBMED]    
Advanced Biomedical Research
Volume 2014, January
January 2014
Pages 1-5