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Thyroid Ultrasound

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Minimally Invasive Thyroidectomy

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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.

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References

  • Ahuja AT (2000) The thyroid and parathyroids. In: Ahuja A, Evans R (eds) Practical head and neck ultrasound. Greenwich Medical Media Ltd, London

    Google Scholar 

  • 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

    Article  PubMed  CAS  Google Scholar 

  • 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

    Article  PubMed  Google Scholar 

  • 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

    Article  PubMed  Google Scholar 

  • 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

    Article  PubMed  Google Scholar 

  • 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

    Article  PubMed  Google Scholar 

  • Baskin HJ, Duick DS, Levine RA (2008) Thyroid ultrasound and ultrasound-guided FNA, 2nd edn. Springer Science and Business Media, New York

    Book  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • Brzac HT (2009) Ultrasonography-guided therapeutic procedures in the neck region. Acta Med Croatica 63(Suppl 3):21–27

    PubMed  Google Scholar 

  • 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

    Google Scholar 

  • 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

    PubMed  CAS  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • 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

    Article  PubMed  CAS  Google Scholar 

  • 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

    Article  PubMed  Google Scholar 

  • Gates JD, Benavides LC, Shriver CD et al (2009) Preoperative thyroid ultrasound in all patients undergoing parathyroidectomy? J Surg Res 155(2):254–260

    Article  PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • 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

    Article  PubMed  Google Scholar 

  • 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

    Article  PubMed  Google Scholar 

  • 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

    Article  PubMed  CAS  Google Scholar 

  • 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

    Article  PubMed  Google Scholar 

  • 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

    PubMed  CAS  Google Scholar 

  • Hegedüs L (2001) Thyroid ultrasound. Endocrinol Metab Clin North Am 30(2):339–360

    Article  PubMed  Google Scholar 

  • 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

    Article  PubMed  CAS  Google Scholar 

  • Hoang JK, Lee WK, Lee M et al (2007) US features of thyroid malignancy: pearls and pitfalls. Radiographics 27:847–865

    Article  PubMed  Google Scholar 

  • Holter MR (2010) Emerging technology in head and neck ultrasonography. Otolaryngol Clin North Am 43(6):1267–1274

    Article  Google Scholar 

  • 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

    Article  PubMed  Google Scholar 

  • Jun P, Chow LC, Jeffrey RB (2005) The sonographic features of papillary thyroid carcinomas: pictorial essay. Ultrasound Q 21(1):39–45

    PubMed  Google Scholar 

  • Kamaya A, Gross M, Akatsu H, Jeffrey RB (2011) Recurrence in the thyroidectomy bed: sonographic findings. AJR Am J Roentgenol 196(1):66–70

    Article  PubMed  Google Scholar 

  • 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

    Article  PubMed  CAS  Google Scholar 

  • 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

    Article  PubMed  Google Scholar 

  • Kharchenko VP, Kotlyarov PM, Mogutov MS et al (2010) Ultrasound diagnostics of thyroid disease. Springer, Berlin/Heidelberg

    Book  Google Scholar 

  • 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

    Article  PubMed  Google Scholar 

  • 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

    Article  PubMed  Google Scholar 

  • 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

    Article  CAS  Google Scholar 

  • 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

    Article  PubMed  Google Scholar 

  • 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

    Article  PubMed  CAS  Google Scholar 

  • 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

    Article  PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • 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

    PubMed  CAS  Google Scholar 

  • 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

    Article  PubMed  Google Scholar 

  • Langer JE, Mandel SJ (2008) Sonographic imaging of cervical lymph nodes in patients with thyroid cancer. Neuroimaging Clin N Am 18(3):479–489

    Article  PubMed  Google Scholar 

  • 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

    Article  PubMed  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • 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

    Article  PubMed  Google Scholar 

  • 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

    Article  PubMed  Google Scholar 

  • Luo S, Kim EH, Dighe M, Kim Y (2011) Thyroid nodule classification using ultrasound elastography via linear discriminant analysis. Ultrasonics 51(4):425–431

    Article  PubMed  Google Scholar 

  • 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

    Article  PubMed  Google Scholar 

  • 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

    PubMed  CAS  Google Scholar 

  • 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

    Article  PubMed  Google Scholar 

  • 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

    Article  PubMed  CAS  Google Scholar 

  • 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

    PubMed  CAS  Google Scholar 

  • 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

    Article  PubMed  Google Scholar 

  • 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

    Article  PubMed  Google Scholar 

  • 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

    PubMed  CAS  Google Scholar 

  • 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

    Article  PubMed  Google Scholar 

  • 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

    Article  PubMed  CAS  Google Scholar 

  • 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

    Article  PubMed  CAS  Google Scholar 

  • Park M, Shin JH, Han BK (2009) Sonography of thyroid nodules with peripheral calcifications. J Clin Ultrasound 37(6):324–328

    Article  PubMed  Google Scholar 

  • 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

    Article  PubMed  CAS  Google Scholar 

  • 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

    Article  PubMed  CAS  Google Scholar 

  • RuchaÅ‚a M, Szczepanek E (2010) Thyroid ultrasound – a piece of cake? Endokrynol Pol 61(3):330–344

    PubMed  Google Scholar 

  • Sakorafas GH, Kokkoris P, Farley DR (2010) Primary thyroid lymphoma (correction of lympoma): diagnostic and therapeutic dilemmas. Surg Oncol 19(4):e124–e129

    Article  PubMed  Google Scholar 

  • Sheth S (2010) Role of ultrasonography in thyroid disease. Otolaryngol Clin North Am 43(2):239–255

    Article  PubMed  Google Scholar 

  • 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

    Article  PubMed  Google Scholar 

  • 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

    Article  PubMed  Google Scholar 

  • 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

    Google Scholar 

  • 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

    Article  PubMed  Google Scholar 

  • 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

    Article  PubMed  Google Scholar 

  • Takashima S, Morimoto S, Ikezoe J et al (1990) CT evaluation of anaplastic thyroid carcinoma. Am J Roentgenol 154:1079–1085

    CAS  Google Scholar 

  • Triggiani V, Guastamacchia E, Licchelli B, Tafaro E (2008) Microcalcifications and psammoma bodies in thyroid tumors. Thyroid 18(9):1017–1018

    Article  PubMed  CAS  Google Scholar 

  • 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

    Article  PubMed  CAS  Google Scholar 

  • 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

    PubMed  Google Scholar 

  • Wong KT, Ahuja AT (2005) Ultrasound of thyroid cancer. Cancer Imaging 5(1):157–166

    Article  PubMed  CAS  Google Scholar 

  • Xu HX (2009) Contrast-enhanced ultrasound: the evolving applications. World J Radiol 1(1):15–24

    Article  PubMed  Google Scholar 

  • Yaturu S, Rainer L (2010) Thyroid nodule with eggshell calcification and oncocytic thyroid cancer. Med Sci Monit 16(3):CS25–CS28

    PubMed  Google Scholar 

  • Yeh HC, Futterweit W, Gilbert P (1996) Micronodulation: ultrasonographic sign of Hashimoto’s thyroiditis. J Ultrasound Med 15:813–819

    PubMed  CAS  Google Scholar 

  • 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

    Article  PubMed  Google Scholar 

  • Zhang B, Jiang YX, Liu JB et al (2010) Utility of contrast-enhanced ultrasound for evaluation of thyroid nodules. Thyroid 20(1):51–57

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Economides Nicosia Endocrinology Center, 9 Iona Nicolaou St., Engomi, Nicosia, 2406, Cyprus

    Irini S. Hadjisavva Ph.D. & Panayiotis A. Economides M.D., Ph.D., FACE

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  1. Irini S. Hadjisavva Ph.D.
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  2. Panayiotis A. Economides M.D., Ph.D., FACE
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Correspondence to Panayiotis A. Economides M.D., Ph.D., FACE .

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Editors and Affiliations

  1. University of Nicosia, Surgery, St. George’s University of London, 46 Makedonitissas Ave 7, Nicosia, 1700, Cyprus

    Dimitrios Linos

  2. , Surgery, Yonsei University of Medicine, onsei-ro, Seodaemun-gu 50, Seoul, 120-752, Korea, Republic of (South Korea)

    Woong Youn Chung

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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

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