Thyroid Ultrasound (last updated 08/07/2018)
(last reviewed 08/07/2018)
(last reviewed 08/07/2018)
Thyroid: Sagittal and transverse scanning of thyroid gland. Measure each lobe in three dimensions.
- Sagittal right carotid
- Three sagittal right thyroid images (lateral, mid, medial), measure mid.
- Three transverse images (upper, mid, lower), measure mid.
- Sagittal left carotid
- Three sagittal left thyroid images (lateral, mid, medial), measure mid.
- Three transverse images (upper, mid, lower), measure mid.
- Transverse midline isthmus and both lobes, measure isthmus
- Transverse midline with color doppler
- Measure nodules if present
- Measure perithyroid lymph nodes if present
Perform routine images above before measuring nodules. Measure nodules in three dimensions, using split screen is best for trv/sag. Label location of nodules (sup, mid, inf; right, left)
Suspicious features for nodules
- Entirely solid
- Hypoechoic
- Microcalcifications (punctate echogenic foci)
- Associated lymphadenopathy
Reassuring features for nodules
- Cystic elements
- Echogenic or isoechoic
- Eggshell calcifications
- Single colloid/bright foci
Post-Thyroidectomy Ultrasound
- Sagittal right and left thyroid bed
- Transverse right and left thyroid bed
- Bilateral neck imaging - look for lymph nodes
Abnormal lymph nodes
- Cystic change
- Microcalcifications
- Asymmetric cortical thickening, effacement of the hilum
- >5 mm short axis