Location of thyroid gland and chest x-ray imaging in children

Transcription

1 Location of thyroid gland and chest x-ray imaging in children Poster No.: C-1073 Congress: ECR 2014 Type: Authors: Keywords: DOI: Scientific Exhibit M. Glisic, E. Sorantin, S. Tschauner; Graz/AT Biological effects, Radiation safety, Radiation effects, Conventional radiography, Thyroid / Parathyroids, Radioprotection / Radiation dose, Pediatric /ecr2014/C-1073 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. Page 1 of 12

2 Aims and objectives Amog many indications for chest x-ray imaging in children, pneumonia remains one of the most frequent indications. Childhood pneumonia is the leading single cause of mortality in children aged less than 5 years according to severe symptoms and special characteristics of the disease in this age group. Study done by Rudan et al estimated median incidence of clinical pneumonia for developing countries was 0.28 episodes per child-year, with an interquartile range episodes per child-year. Incidence of pneumonia indicates that chest x-ray imaging is one of the most frequent imaging methode done in childhood. The aim of this study was to determine the thyroid position in regard to cervical vertebral bodies in children with respect to current guidelines of chest x-rays. Methods and materials Study based on population of 109 children age 0 to 18 years (mean age 7.71 ±5.66), divided into six age groups: infants (0-1 years of age), toddlers (1-3), preschoolers (3-5), middle childhood ( 6-11), young teens (12-14) and teenagers (15-18). Figure 2 shows distribution of mean age of children in each age group, percentage of children in each age group and gender distribution of children in each group. Thyroid gland position was determined on MRI studies of the cervical spine. Position of the upper and lower pole as well as the isthmus of thyroid gland were determined. Age and sex dependently of the determined positions was analyzed using Kruskal Wallis. Figures 3, 4 and 5 show children distribution regarding to location of particular poles of thyroid gland. The inferior poles of thyroid gland in 51% of children in all age groups was located at level of seventh cervical vertebra. The superiod poles of thyroid lobes in 31 % of children was located at level of C5, and isthmus in 32% of children at level of C6. Images for this section: Page 2 of 12

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4 Fig. 1: Position of upper pole, lower pole and isthmus were determined using MRI images. Location was determined in regard to cervical vertebrae. Page 4 of 12

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6 Fig. 2 Fig. 3 Page 6 of 12

7 Fig. 4 Page 7 of 12

8 Fig. 5 Page 8 of 12

9 Results In all children the determined positions were on the following positions; upper pole : infants C4-5 (71%), toddlers C4-5 (35%), preschoolers C5-6 (37%), middle childhood C5-6 (45%), young teens C5-6 (37%), teenagers C7 (40%), isthmus: infants C5-6 (71%), toddlers C5-6 (58,82%), preschoolers C6-7 (40%), middle childhood C6-7 (36%), young teens C5-6 (37%) teenagers C6-7 (45%) and lower pole : infants C6 (57%), toddlers C7 (58%), preschoolers C7 (81%), middle childhood Th1 (50%), young teens C6 (43%) and teenagers C7 (45%). There was no sex dependency but there was a statistically significant difference between the age groups (Fig. 6 and 7 ). It seems the thyroid is descending over time. Images for this section: Page 9 of 12

10 Fig. 6 Page 10 of 12

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12 Conclusion Thyroid position was at a level between C4 to C7, with a trend to descend to more caudal positions by age. In guidelines about quality criteria of pediatric chest x-rays the thyroid positions has to be considered. Personal information Marija Glisic Medical Student School of Medicine, University of Belgrade Erich Sorantin Univ.-Prof.Dr. at Medical University of Graz Sebastian Tschauner M.D. Medical University of Graz References ftp://ftp.cordis.lu/pub/fp5-euratom/docs/eur16260.pdf Epidemiology and etiology of childhood pneumonia Igor Rudan a, Cynthia Boschi-Pinto b, Zrinka Biloglav c, Kim Mulholland d, Harry Campbell Page 12 of 12