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Ultrasound of Thyroid Nodules

  • Susan J. MandelEmail author
  • Jill E. Langer
Chapter

Abstract

Thyroid sonography is a valuable tool for cancer risk assessment of thyroid nodules. Over the last 25 years, many reports have analyzed the association of individual sonographic features with thyroid cancer. More recently the focus has shifted toward nodule classification by pattern recognition, which relies on the simultaneous presence of several features in a thyroid nodule that together will either increase or decrease suspicion for malignancy. This chapter will first review the major grayscale sonographic features exhibited by thyroid nodules: echogenicity, composition, calcifications, margins, shape, and vascularity, as well as the spectrum of nodule appearances within each category. Since 2009, several groups from individual institutions have proposed pattern classification systems, all termed TIRADS (Thyroid Imaging Reporting and Data System). Currently, three main versions of TIRADS exist, with some differences in pattern nomenclature and classification. Both the American Thyroid Association (ATA) and the American Association of Clinical Endocrinologists have recently presented alternative pattern recognition systems based upon atlases of images. These systems are promising because of the more robust reproducibility in nodule classification compared to identification of individual features. However, their clinical utility for risk of malignancy assessment depends upon both validation in other populations and importantly incorporating them into FNA decision-making in the broader context of the individual patient (see Chap.  12 “Ultrasound-Guided Fine-Needle Aspiration of Thyroid Nodules”).

Keywords

Thyroid ultrasound Echogenicity Margins Calcifications TIRADS Patterns Thyroid cancer Thyroid nodules 

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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Division of Endocrinology, Diabetes and Metabolism, Department of MedicinePerelman School of Medicine, University of PennsylvaniaPhiladelphiaUSA
  2. 2.Department of RadiologyPerelman School of Medicine, University of PennsylvaniaPhiladelphiaUSA

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