Diabetes Endocrine and Metabolism Pediatric Unit, Kasr Al-Ainy Medical School, Children’s Hospital, Cairo University, Egypt
Department of Pediatrics, 6th of October Central Hospital, Ministry of Health and Population, Cairo, Egypt
Department of Radiology, Kasr Al-Ainy Medical School, Cairo University, Egypt
Pediatr Endocrinol Diabetes Metab 2026; 32 (3): 172-180
Thyroid scintigraphy and ultrasonography are the two primary imaging modalities widely used for thyroid visualization in pediatric patients with congenital hypothyroidism (CH). These modalities provide complementary information. In resource-limited settings, adopting a stepwise approach for selecting the initial imaging modality is essential.
To compare the diagnostic performance of thyroid ultrasonography, thyroid scintigraphy, and combined modalities in categorizing the type of thyroid dysgenesis.
This cross-sectional study included 56 patients with CH due to thyroid dysgenesis. 99mTc thyroid scintigraphy was performed in all patients at diagnosis. Participants underwent thyroid ultrasonographic examination.
Ultrasonography showed the highest sensitivity in diagnosing thyroid hypoplasia (75%) but lacked sensitivity in detecting ectopic thyroid. Thyroid scintigraphy sensitivity was highest for diagnosing ectopic glands and agenesis (100%) but less sensitive for hypoplasia (54.5%). Combining both imaging modalities demonstrated a sensitivity and accuracy of 100% across all types of dysgenesis.
Combined thyroid scintigraphy and ultrasonography demonstrated superior diagnostic accuracy, enabling precise characterization of thyroid dysgenesis. If the combined approach is not feasible, initiating thyroid scintigraphy is recommended as the first-line imaging modality and neck ultrasonography serves as a complementary second line imaging technique.
congenital hypothyroidism, thyroid dysgenesis, ultrasonography, thyroid scintigraphy
