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Feature Illustration: Echogenicity, Composition, and Shape

  • Jill E. LangerEmail author
Chapter
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Abstract

Sonographic assessment of nodular features has emerged as the primary imaging means to evaluate the malignant potential of thyroid nodules. Although no single sonographic feature can be used to detect all cancerous nodules, some sonographic features such as microcalcifications, marked hypoechogenicity, infiltrative margins, and taller-than-wide shape are relatively specific for thyroid cancer. Other features, such as an entirely cystic nodule or a mixed cystic and solid nodule with spongiform composition, carry a very low risk of malignancy. By using sonographic criteria to stratify risk of malignancy, invasive and costly evaluations can be avoided in many patients with benign nodules.

Keywords

Thyroid nodules Thyroid malignancy Echogenicity Hypoechoic Hyperechoic Isoechoic Composition Cystic change Taller-than-wide shape 

Supplementary material

Video 10.1A

Cystic papillary thyroid carcinoma. (a) Transverse and (b) sagittal sweeps though the right lobe of the thyroid show a 3.5 cm complex cystic nodule that has irregular internal soft tissue elements that are nodular and have jagged borders (MP4 2781 kb)

Video 10.1B

Cystic papillary thyroid carcinoma. (a) Transverse and (b) sagittal sweeps though the right lobe of the thyroid show a 3.5 cm complex cystic nodule that has irregular internal soft tissue elements that are nodular and have jagged borders (MP4 2781 kb)

Video 10.2A

Cystic papillary thyroid carcinoma. (a) Transverse gray scale and (b) color Doppler sweeps through a predominantly cystic nodule show a solid papillary soft tissue projection that has an irregular margin and abundant vascular flow. (c) FNAS was directed into the solid component and was diagnostic for papillary thyroid carcinoma (MP4 3845 kb)

Video 10.2B

Cystic papillary thyroid carcinoma. (a) Transverse gray scale and (b) color Doppler sweeps through a predominantly cystic nodule show a solid papillary soft tissue projection that has an irregular margin and abundant vascular flow. (c) FNAS was directed into the solid component and was diagnostic for papillary thyroid carcinoma (MP4 3845 kb)

Video 10.2C

Cystic papillary thyroid carcinoma. (a) Transverse gray scale and (b) color Doppler sweeps through a predominantly cystic nodule show a solid papillary soft tissue projection that has an irregular margin and abundant vascular flow. (c) FNAS was directed into the solid component and was diagnostic for papillary thyroid carcinoma (MP4 3845 kb)

Video 10.3

Spongiform appearance of a nodule. Transverse sweep of the left lobe shows a nodule of mixed echogenicity that has interspersed cystic spaces throughout occupying more than 50 % of the nodule. This appearance has been termed spongiform and carries and extremely low risk for malignancy (MP4 1651 kb)

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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department of RadiologyThe Perelman School of Medicine at the University of PennsylvaniaPhiladelphiaUSA

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