Ultrasound of Thyroid Nodules

Abstract

Thyroid nodules are a common finding in the general population. Ultrasonography is the most sensitive imaging tool for diagnosing thyroid nodules. However, sonographic differentiation of hormonally active versus inactive nodules, and in particular benign versus malignant nodules, remains unreliable. In this context, thyroid scintigraphy has its clinical significance predominantly in diagnosing hormonal activity of thyroid nodules. However, most nodules are benign and a significant number of patients undergo surgery for diagnostic rather than for therapeutic reasons. Efforts of the past years aimed to improve sonographic risk stratification, to predict malignancy of thyroid nodules through standardized diagnostic assessment of validated risk factors, in order to select patients who require further diagnostic workup. In the last years, several imaging and reporting systems, giving standardized categories with rates of malignancy, were evaluated as a basis for further clinical management. Recent technological developments, such as elastography, also show promising data and might be implemented into clinical practice. Ultrasound-guided fine needle aspiration is the key element in the diagnosis of sonographically suspicious thyroid nodules and significantly contributes to the diagnosis of malignancy versus benignity.

Frequency of Thyroid Nodules in Patients with ?-Thalassemias in Southern Iran

“…Although thyroid nodules were not more prevalent than the normal population (16,17), Govoni et al (12) found a papillary thyroid carcinoma (PTC) in 2 females and 3 males (31% ), aged 32-57 years, with iron overload and hepatitis C infection (HCV).…”

“…Because thyroid nodules are a common finding in the general population, the major challenge for the clinician taking care of patients with thalassemia is to determine which of these nodules are clinically important (16,17).…”

A Review of the Pathology, Diagnosis and Management of Colloid Goitre

“…About 80-85% of all thyroid abnormalities are diffuse hyperplasia of the thyroid gland. 21,22 Diffuse hyperplasia embodies the following ultrasound attributes:…”

“…30 Ultrasound characteristics of common colloid nodules include well-defined margins and an intact capsule of lesions, and the thyroid gland capsule should be preserved (Figure 2). 22,27,29 Doppler ultrasound can be used to determine whether there is internal vascular flow. When the nodule is isoechoic or hyperechoic, a thin peripheral hypoechoic halo is typically seen, most likely caused by perinodular blood vessels and mild oedema or compression of the adjacent normal parenchyma.…”

Schilddrüsen-Elastografie

“…Zusammenfassend kann sowohl mit der qualitativen Strain Elastografie als auch der quantitativen Shear-Wave Elastografie in Ergänzung zur B-Bild-Sonografie die Differenzierung von benignen und malignen Schilddrüsenknoten deutlich verbessert werden [35]. Die Kombination aus B-Bild-Sonografie und Elastografie erreicht bei der Dignitätsbeurteilung von Schilddrüsenknoten Sensitivitäten und Spezifitäten, die der klassischen Feinnadelaspirationszytologie mindestens vergleichbar sind.…”