COMPARATIVE CHARACTERISTIC OF ULTRASOUND CHANGES OF THYROID GLAND IN CHILDREN WITH DISTURBED AND NORMAL HEART RHYTHM
Keywords:thyroid gland, ultrasound diagnostics, heart rhythm, children.
Purpose. Determination and comparative characteristic of ultrasound changes of thyroid gland in children with disturbed and normal heart rhythm to justify the need for a ultrasound screening study as a method of early diagnosis and prevention of thyroid pathology. Materials and Methods. The ultrasound examination of the thyroid gland has been carried out for 142 children aged from 3 to 17 years old. Out of these number 118 children with cardiac rhythm disorders, were included in Observation group I, the second Comparative group included 24 children with normal heart rhythm. The ultrasound evaluation of the thyroid gland was performed using the ultrasound machine «Esaote MyLab50» with a linear sensor with a frequency of 7.5–12 MHz according to the generally accepted Brunn method, which consists of determining the three dimensions of the length, width and height of the ultrasound, and the determination of the volume by the formula of ellipse (0,479 × А × В × С). Statistical processing of data was carried out using conventional variational statistical methods using a licensed software package Statistica for Windows 6.1.RU, serial number АХХR712D833214SAN5. We used nonparametric statistical methods: the «2 × 2 Table», the Chi-square (df = 1). Differences р < 0.05 were considered statistically significant. Results. The pathological changes of the thyroid gland were recorded in 55.9 % of children with heart rhythm disorders (more often with sinus tachycardia) and in 12.5 % of children with normal heart rhythm. In children with heart rhythm disturbances, the following ultrasound changes in the thyroid gland were diagnosed: increased volume (9.32 %), asymmetric decrease of the volume of one of the thyroid lobes (1,7 %), pathological inclusions in the form of shadows of different echogenicity (16.95 %), changes in echogenicity of parenchyma (11.02 %), increased vascular pulsation (16.95 %). In group II, the 4.17 % of children with thyroid volume increase and 8.33 % of children with pathological inclusions in the thyroid gland, had normal heart rhythm. Ultrasound abnormalities of the thyroid gland were in 25.76 % of children under 9 years of age (47.06 % in girls and 52.94 % in boys) and in 74.24 % of children aged 10 to 17 years (61.22 % in girls and 38.78% in boys) аnd diagnosed in 78.79 % of patients living in industrial areas of the city and 21.21 % of children living in more environmentally friendly areas. Conclusion. In ultrasound examination, pathological changes of the thyroid gland were recorded in 55.93 % of children with heart rhythm disorders, more often in girls (61.22 %) aged 10 to 17 years of patients living in industrial areas of the city. So, for timely urgent issues timely early diagnostics of endocrine thyroid pathology, including cases of malignant neoplasms, it is necessary to conduct a screening ultrasound examination of the thyroid gland in children, and especially those with heart rhythm disorders living near large industrial enterprises and girls of prepubertal and pubertal age.
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