Ultrasound Imaging of Thyroid Pathologies: A Pictorial Review

Abstract

With its complex embryological origin, the thyroid can be affected by various congenital, developmental, benign, and malignant pathologies. Ultrasound, which is free from radiation and offers good spatial resolution, is the initial modality of choice in congenital hypothyroidism and is used in conjunction with scintigraphy. High-resolution ultrasound also aids in early diagnosis, risk stratification, and follow-up of nodules. While fine-needle aspiration cytology is the preferred method for further evaluation of thyroid nodules, ultrasound guidance reduces the likelihood of obtaining nondiagnostic samples. Numerous risk stratification guidelines for thyroid nodules have been developed by various societies over the past decade, with the most popular being the American College of Radiology—Thyroid Imaging Reporting and Data System. A comprehensive understanding of the varying morphological appearances of thyroid nodules and the consistent use of risk stratification guidelines can accurately detect incidental malignancies while avoiding unnecessary intervention in seemingly benign nodules.