Abstract
Thyroid and neck ultrasonography is an essential tool for physicians treating patients with thyroid diseases and is currently considered an extension to physical examination. Ultrasound accurately and reliably detects and characterizes thyroid nodules, offers guidance during fine needle aspiration biopsy, and aids in monitoring and follow-up. Ultrasound has a central and invaluable role in managing thyroid cancer and in localizing parathyroid lesions. Diagnostic neck sonography is rapidly advancing, and newer thyroid interventional ultrasound techniques offer much promise for the future. In this chapter, we address the main ultrasonographic findings in common thyroid pathologies and parathyroid disease so as to help the reader understand the basics of this technology.
Keywords
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Ahuja AT (2000) The thyroid and parathyroids. In: Ahuja A, Evans R (eds) Practical head and neck ultrasound. Greenwich Medical Media Ltd, London
Ahuja A, Chick W, King W, Metreweli C (1996) Clinical significance of the comet-tail artifact in thyroid ultrasound. J Clin Ultrasound 24(3):129–133
Albayrak Y, Albayrak F, Kaya Z et al (2011) A case of papillary carcinoma in a thyroglossal cyst without a carcinoma in the thyroid gland. Diagn Cytopathol 39(1):38–41
Anderson L, Middleton WD, Teefey SA et al (2010) Hashimoto thyroiditis: part 2, sonographic analysis of benign and malignant nodules in patients with diffuse Hashimoto thyroiditis. AJR Am J Roentgenol 195(1):216–222
Baek JH, Kim YS, Lee D et al (2010) Benign predominantly solid thyroid nodules: prospective study of efficacy of sonographically guided radiofrequency ablation versus control condition. AJR Am J Roentgenol 194(4):1137–1142
Baskin HJ (2004) Detection of recurrent papillary thyroid carcinoma by thyroglobulin assessment in the needle washout after fine-needle aspiration of suspicious lymph nodes. Thyroid 14(11):959–963
Baskin HJ, Duick DS, Levine RA (2008) Thyroid ultrasound and ultrasound-guided FNA, 2nd edn. Springer Science and Business Media, New York
Brunese L, Romeo A, Iorio S et al (2008) A new marker for diagnosis of thyroid papillary cancer: B-flow twinkling sign. J Ultrasound Med 27(8):1187–1194
Brzac HT (2009) Ultrasonography-guided therapeutic procedures in the neck region. Acta Med Croatica 63(Suppl 3):21–27
Cai S, Liu H, Li WB et al (2010) Ultrasonographic features of medullary thyroid carcinoma and their diagnostic values. Chin Med J (Engl) 123(21):3074–3078
Cantisani V, Catania A, De Antoni E et al (2010) Is pattern III as evidenced by US color-Doppler useful in predicting thyroid nodule malignancy? Large-scale retrospective analysis. Clin Ter 161(2):e49–e52
Chan BK, Desser TS, McDougall IR et al (2003) Common and uncommon sonographic features of papillary thyroid carcinoma. J Ultrasound Med 22(10):1083–1090
Cunha N, Rodrigues F, Curado F et al (2007) Thyroglobulin detection in fine-needle aspirates of cervical lymph nodes: a technique for the diagnosis of metastatic differentiated thyroid cancer. Eur J Endocrinol 157:101–107
Frates MC, Benson CB, Charboneau JW et al (2005) Management of thyroid nodules detected at US: society of radiologists in ultrasound consensus conference statement. Radiology 237(3):794–800
Gates JD, Benavides LC, Shriver CD et al (2009) Preoperative thyroid ultrasound in all patients undergoing parathyroidectomy? J Surg Res 155(2):254–260
Gietka-Czernel M, Kochman M, Bujalska K et al (2010) Real-time ultrasound elastography – a new tool for diagnosing thyroid nodules. Endokrynol Pol 61(6):652–657
Giusti M, Dolcino M, Vera L et al (2009) Institutional experience of PTH evaluation on fine-needle washing after aspiration biopsy to locate hyperfunctioning parathyroid tissue. J Zhejiang Univ Sci B 10(5):323–330
Gul K, Dirikoc A, Kiyak G et al (2010) The association between thyroid carcinoma and Hashimoto’s thyroiditis: the ultrasonographic and histopathologic characteristics of malignant nodules. Thyroid 20(8):873–878
Guth S, Theune U, Aberle J et al (2009) Very high prevalence of thyroid nodules detected by high frequency (13 MHz) ultrasound examination. Eur J Clin Invest 39(8):699–706
Halenka M, Frysak Z, Koranda P, Kucerova L (2008) Cystic parathyroid adenoma within a multinodular goiter: a rare cause of primary hyperparathyroidism. J Clin Ultrasound 36(4):243–246
Hari Kumar KV, Pasupuleti V, Jayaraman M et al (2009) Role of thyroid Doppler in differential diagnosis of thyrotoxicosis. Endocr Pract 15(1):6–9
Hegedüs L (2001) Thyroid ultrasound. Endocrinol Metab Clin North Am 30(2):339–360
Hegedus L, Perril H, Poulsen LR et al (1983) The determination of thyroid volume by ultrasound and its relationship to body weight, age and sex in normal subjects. J Clin Endocrinol Metab 56(2):260–263
Hoang JK, Lee WK, Lee M et al (2007) US features of thyroid malignancy: pearls and pitfalls. Radiographics 27:847–865
Holter MR (2010) Emerging technology in head and neck ultrasonography. Otolaryngol Clin North Am 43(6):1267–1274
Hwang HS, Orloff LA (2011) Efficacy of preoperative neck ultrasound in the detection of cervical lymph node metastasis from thyroid cancer. Laryngoscope 121(3):487–491
Jun P, Chow LC, Jeffrey RB (2005) The sonographic features of papillary thyroid carcinomas: pictorial essay. Ultrasound Q 21(1):39–45
Kamaya A, Gross M, Akatsu H, Jeffrey RB (2011) Recurrence in the thyroidectomy bed: sonographic findings. AJR Am J Roentgenol 196(1):66–70
Kanotra SP, Lateef M, Kirmani O (2008) Non-surgical management of benign thyroid cysts: use of ultrasound-guided ethanol ablation. Postgrad Med J 84(998):639–643
Kessler A, Rappaport Y, Blank A et al (2003) Cystic appearance of cervical lymph nodes is characteristic of metastatic papillary thyroid carcinoma. J Clin Ultrasound 31(1):21–25
Kharchenko VP, Kotlyarov PM, Mogutov MS et al (2010) Ultrasound diagnostics of thyroid disease. Springer, Berlin/Heidelberg
Kim MJ, Kim EK, Park SI et al (2008) US-guided fine-needle aspiration of thyroid nodules: indications, techniques, results. Radiographics 28(7):1869–1886
Kim SH, Kim BS, Jung SL et al (2009a) Ultrasonographic findings of medullary thyroid carcinoma: a comparison with papillary thyroid carcinoma. Korean J Radiol 10(2):101–105
Kim MJ, Kim EK, Kim BM et al (2009b) Thyroglobulin measurement in fine-needle aspirate washouts: the criteria for neck node dissection for patients with thyroid cancer. Clin Endocrinol (Oxf) 70(1):145–151
Kim JH, Lee JH, Shong YK et al (2009c) Ultrasound features of suture granulomas in the thyroid bed after thyroidectomy for papillary thyroid carcinoma with an emphasis on their differentiation from locally recurrent thyroid carcinomas. Ultrasound Med Biol 35(9):1452–1457
King AD, Ahuja AT, To EW (2000) Staging papillary carcinoma of the thyroid: magnetic resonance imaging vs ultrasound of the neck. Clin Radiol 55(3):222–226
Kovatcheva RD, Vlahov JD, Shinkov AD et al (2010) High-intensity focused ultrasound to treat primary hyperparathyroidism: a feasibility study in four patients. AJR Am J Roentgenol 195(4):830–835
Kumar KV, Vamsikrishna P, Verma A et al (2009) Utility of colour Doppler sonography in patients with Graves’ disease. West Indian Med J 58(6):566–570
Kwak JY, Kim EK, Moon HJ et al (2009) Parathyroid incidentalomas detected on routine ultrasound-directed fine-needle aspiration biopsy in patients referred for thyroid nodules and the role of parathyroid hormone analysis in the samples. Thyroid 19(7):743–748
Landry CS, Grubbs EG, Busaidy NL et al (2011) Cystic lymph nodes in the lateral neck as indicators of metastatic papillary thyroid cancer. Endocr Pract 17(2):240–244
Langer JE, Mandel SJ (2008) Sonographic imaging of cervical lymph nodes in patients with thyroid cancer. Neuroimaging Clin N Am 18(3):479–489
Lee MJ, Kim EK, Kwak JY, Kim MJ (2009) Partially cystic thyroid nodules on ultrasound: probability of malignancy and sonographic differentiation. Thyroid 19(4):341–346
Lee SK, Rho BH, Woo SKJ (2010a) Hürthle cell neoplasm: correlation of gray-scale and power Doppler sonographic findings with gross pathology. J Clin Ultrasound 38(4):169–176
Lee S, Shin JH, Han BK, Ko EY (2010b) Medullary thyroid carcinoma: comparison with papillary thyroid carcinoma and application of current sonographic criteria. AJR Am J Roentgenol 194(4):1090–1094
Levy JM, Kandil E, Yau LC et al (2011) Can ultrasound be used as the primary screening modality for the localization of parathyroid disease prior to surgery for primary hyperparathyroidism? A review of 440 cases. ORL J Otorhinolaryngol Relat Spec 73(2):116–120
Luo S, Kim EH, Dighe M, Kim Y (2011) Thyroid nodule classification using ultrasound elastography via linear discriminant analysis. Ultrasonics 51(4):425–431
Lyshchik A, Drozd V, Reiners C (2004) Accuracy of three-dimensional ultrasound for thyroid volume measurement in children and adolescents. Thyroid 14(2):113–120
Marqusee E, Benson CB, Frates MC et al (2000) Usefulness of ultrasonography in the management of nodular thyroid disease. Ann Intern Med 133(9):696–700
Mihai R, Parker AJ, Roskell D, Sadler GP (2009) One in four patients with follicular thyroid cytology (THY3) has a thyroid carcinoma. Thyroid 19(1):33–37
Mihailescu DV, Schneider AB (2008) Size, number, and distribution of thyroid nodules and the risk of malignancy in radiation-exposed patients who underwent surgery. J Clin Endocrinol Metab 93(6):2188–2193
Miyakawa M, Tsushima T, Onoda N et al (1992) Thyroid ultrasonography related to clinical and laboratory findings in patients with silent thyroiditis. J Endocrinol Invest 15(4):289–295
Moon WJ, Baek JH, Jung SL et al (2011) Ultrasonography and the ultrasound-based management of thyroid nodules: consensus statement and recommendations. Korean J Radiol 12(1):1–14
Moreno MA, Agarwal G, de Luna R et al (2011) Preoperative lateral neck ultrasonography as a long-term outcome predictor in papillary thyroid cancer. Arch Otolaryngol Head Neck Surg 137(2):157–162
Nishihara E, Amino N, Ohye H et al (2009) Extent of hypoechogenic area in the thyroid is related with thyroid dysfunction after subacute thyroiditis. J Endocrinol Invest 32(1):33–36
Omori N, Omori K, Takano K (2008) Association of the ultrasonographic findings of subacute thyroiditis with thyroid pain and laboratory findings. Endocr J 55(3):583–588
Pacini F, Schlumberger M, Dralle H et al (2006) European consensus for the management of patients with differentiated thyroid carcinoma of the follicular epithelium. Eur J Endocrinol 154(6):787–803
Papini E, Guglielmi R, Bianchini A et al (2002) Risk of malignancy in nonpalpable thyroid nodules: predictive value of ultrasound and color-Doppler features. J Clin Endocrinol Metab 87(5):1941–1946
Park M, Shin JH, Han BK (2009) Sonography of thyroid nodules with peripheral calcifications. J Clin Ultrasound 37(6):324–328
Rago T, Vitti P, Chiovato L et al (1998) Role conventional ultrasonography and colour flow Doppler sonography in predicting malignancy in ‘cold’ thyroid nodules. Eur J Endocrinol 138:41–46
Rago T, Scutari M, Santini F et al (2010) Real-time elastosonography: useful tool for refining the presurgical diagnosis in thyroid nodules with indeterminate or nondiagnostic cytology. J Clin Endocrinol Metab 95(12):5274–5280
Ruchała M, Szczepanek E (2010) Thyroid ultrasound – a piece of cake? Endokrynol Pol 61(3):330–344
Sakorafas GH, Kokkoris P, Farley DR (2010) Primary thyroid lymphoma (correction of lympoma): diagnostic and therapeutic dilemmas. Surg Oncol 19(4):e124–e129
Sheth S (2010) Role of ultrasonography in thyroid disease. Otolaryngol Clin North Am 43(2):239–255
Sillery JC, Reading CC, Charboneau JW et al (2010) Thyroid follicular carcinoma: sonographic features of 50 cases. AJR Am J Roentgenol 194(1):44–54
Slapa RZ, Jakubowski WS, Slowinska-Srzednicka J, Szopinski KT (2011) Advantages and disadvantages of 3D ultrasound of thyroid nodules including thin slice volume rendering. Thyroid Res 4(1):1
Solbiati L, Charboneau JW, Osti V et al (2005) The thyroid gland. In: Rumack CM, Wilson SR, Charbonewu JW, Johnson JAM (eds) Diganostic ultrasound, 3rd edn. Elsevier/Mosby, Missouri
Spiezia S, Garberoglio R, Milone F et al (2009) Thyroid nodules and related symptoms are stably controlled two years after radiofrequency thermal ablation. Thyroid 19(3):219–225
Sung JY, Kim YS, Choi H et al (2011) Optimum first-line treatment technique for benign cystic thyroid nodules: ethanol ablation or radiofrequency ablation? AJR Am J Roentgenol 196(2):W210–W214
Takashima S, Morimoto S, Ikezoe J et al (1990) CT evaluation of anaplastic thyroid carcinoma. Am J Roentgenol 154:1079–1085
Triggiani V, Guastamacchia E, Licchelli B, Tafaro E (2008) Microcalcifications and psammoma bodies in thyroid tumors. Thyroid 18(9):1017–1018
Valcavi R, Riganti F, Bertani A et al (2010) Percutaneous laser ablation of cold benign thyroid nodules: a 3-year follow-up study in 122 patients. Thyroid 20(11):1253–1261
Wienke JR, Chong WK, Fielding JR et al (2003) Sonographic features of benign thyroid nodules: interobserver reliability and overlap with malignancy. J Ultrasound Med 22(10):1027–1031
Wong KT, Ahuja AT (2005) Ultrasound of thyroid cancer. Cancer Imaging 5(1):157–166
Xu HX (2009) Contrast-enhanced ultrasound: the evolving applications. World J Radiol 1(1):15–24
Yaturu S, Rainer L (2010) Thyroid nodule with eggshell calcification and oncocytic thyroid cancer. Med Sci Monit 16(3):CS25–CS28
Yeh HC, Futterweit W, Gilbert P (1996) Micronodulation: ultrasonographic sign of Hashimoto’s thyroiditis. J Ultrasound Med 15:813–819
Yuan WH, Chiou HJ, Chou YH et al (2006) Gray-scale and color Doppler ultrasonographic manifestations of papillary thyroid carcinoma: analysis of 51 cases. Clin Imaging 30(6):394–401
Zhang B, Jiang YX, Liu JB et al (2010) Utility of contrast-enhanced ultrasound for evaluation of thyroid nodules. Thyroid 20(1):51–57
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2012 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Hadjisavva, I.S., Economides, P.A. (2012). Thyroid Ultrasound. In: Linos, D., Chung, W. (eds) Minimally Invasive Thyroidectomy. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-23696-9_3
Download citation
DOI: https://doi.org/10.1007/978-3-642-23696-9_3
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-23695-2
Online ISBN: 978-3-642-23696-9
eBook Packages: MedicineMedicine (R0)