Ultrasound of thyroid, parathyroid glands and neck lymph nodes

Abstract

In the past 15 years high-frequency B-mode sonography and colour-power Doppler have become the most important and most widely employed imaging modalities for the study of the neck, in particular for thyroid gland, parathyroids and lymph nodes. Sonography allows not only the detection but often also the characterization of the diseases of these organs, distinguishing benign from malignant lesions with high sensitivity and specificity, which could be further improved by the employ of ultrasound contrast agents and harmonic imaging. Although no single sonographic criterion is specific for benign or malignant nature of the lesions, the combination of different signs can be markedly helpful to speed up the diagnostic process. Fine-needle aspiration biopsy (FNAB) remains the most accurate modality for the definitive assessment of thyroid gland nodules and of any doubtful case of nodal disease. In association with clinical findings and serum levels of parathormone, FNAB has specificity close to 100% for the characterization of parathyroid adenomas. A combined approach with sonography and FNAB is generally highly effective.

Institutional experience of PTH evaluation on fine-needle washing after aspiration biopsy to locate hyperfunctioning parathyroid tissue

“…The most frequent cause of false positive results is the concomitant presence of thyroid nodules (Allendorf et al, 2003;Mihai et al, 2006). Normal parathyroid glands are not visible on US and false positive results are due to thyroid nodules, blood vessels, oesophagus, long collum muscle, and lateral cervical lymph nodes, while false negative results are due to atypical parathyroid location (Solbiati et al, 2001). Thyroid nodules were reported during neck US in 20%~80% of PHP cases (Abraham et al, 2007;Erbil et al, 2007;Lumachi et al, 2003;Marcocci et al, 1998;Mihai et al, 2006).…”

Can Quantitative Diffusion-Weighted MR Imaging Differentiate Benign and Malignant Cold Thyroid Nodules? Initial Results in 25 Patients

“…Indeterminate cytologic findings demand additional diagnostic methods and, if necessary, surgery. 6 In addition, USgFNAC is an invasive procedure and uncomfortable for the patient. Thus, there is a demand for both noninvasive and more accurate diagnostic methods for further evaluation of cold thyroid nodules.…”

Three-Dimensional Ultrasonography for Volume Measurement of Thyroid Nodules in Children

“…1 The great flexibility of ultrasonography, its comparatively low cost, and other advantages, such as real-time imaging and the use of nonionizing radiation with no known bioeffects, make ultrasonography a first-choice diagnostic procedure in these patients. Results of North American and European thyroid association surveys have shown that ultrasonography is the most commonly used method of visualization in patients with thyroid nodules at the stage of initial diagnosis: 80% of endocrinologists in Europe and 34% in North America use sonography for determination of thyroid and nodule size and evaluation of their structure.…”