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Thyroid Cancer pp 293–314Cite as

Ultrasonic Imaging of the Thyroid Gland

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Abstract

Since the introduction in the 1970s of ultrasonography (US) for diagnostic and therapeutic purposes in clinical thyroidology, US has become widely accepted, increasingly employed, and mastered not only by specialist in diagnostic imaging. It is recommended by the thyroid specialist societies as the initial imaging method for individuals with thyroid disorders, especially when there is suspicion of thyroid malignancy. The technology is increasingly mastered by physicians who are in charge of such patients, whether for the initial workup or for follow-up. This chapter focuses, in detail, on basic aspects of B-mode US, as well as color- and power Doppler US, and discusses elastosonography. Strengths and weaknesses of these modalities are covered and characteristic findings are highlighted pictorially. Much emphasis is on the technique of US-guided fine-needle aspiration as a diagnostic tool, since this is also the prerequisite for the increasing use of US-guided therapy and the decrease in diagnostic thyroidectomies. The use of percutaneous ethanol injection (PEI) therapy, interstitial laser photocoagulation (ILP), and radiofrequency ablation (RFA) is covered, although their use in thyroid malignancy is still in its infancy.

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Notes

  1. 1.

    Gray-scale resolution is the maximum number of gray shades available in a system, broken into steps from white to black.

  2. 2.

    Temporal resolution is the number of times per second the ultrasound system scans. This is displayed as frames per second.

  3. 3.

    Axial resolution defines the ability of the ultrasound transducer to detect two closely spaced reflectors along the direction of sound travel and is directly proportional to the pulse length. The distribution of frequencies present in a beam varies with pulse length: the frequency distribution broadens as the pulse gets shorter. The axial resolution of the imaging system depends on the pulse length: the shorter the pulse length, the better the axial resolution. Short pulses have the broadest frequency distribution but the best axial resolution.

  4. 4.

    Lateral resolution defines the ability of the ultrasound transducer to discern two points perpendicular to the direction of propagation.

  5. 5.

    Contrast resolution defines the ability to discriminate the differences of acoustic impedance among tissues. It is affected by echo amplitude and tissue attenuation.

  6. 6.

    Vascular resolution describes sensitivity for the detection of very low Doppler signal intensities and Doppler frequency shifts.

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Authors and Affiliations

  1. Endocrinology Unit, Regina Apostolorum Hospital, Rome, Albano Laziale, Italy

    Enrico Papini MD, FACE

  2. Department of Diagnostic Imaging and Interventional Radiology, Regina Apostolorum Hospital, Via S, Francesco, 50, Rome, Albano Laziale, 00041, Italy

    Claudio Maurizio Pacella MD

  3. Endocrinology Unit, Arcispedale S. Maria Nuova - IRCCS, Reggio Emilia, Italy

    Andrea Frasoldati MD, PhD

  4. Department of Endocrinology and Metabolism, Odense University Hospital and University of Southern Denmark, Kloevervaenget 6, 6th floor, Odense, Funen, 5000 C, Denmark

    Laszlo Hegedüs MD, DMSc

Authors
  1. Enrico Papini MD, FACE
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  2. Claudio Maurizio Pacella MD
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  3. Andrea Frasoldati MD, PhD
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  4. Laszlo Hegedüs MD, DMSc
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Corresponding author

Correspondence to Laszlo Hegedüs MD, DMSc .

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Editors and Affiliations

  1. Department of Medicine, MedStar Washington Hospital Center Georgetown University School of Medicine, Washington, DC, USA

    Leonard Wartofsky

  2. Nuclear Medicine Research MedStar Research Institute and Washington Hospital Center, Georgetown University School of Medicine Washington Hospital Center, Washington, DC, USA

    Douglas Van Nostrand

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Papini, E., Pacella, C.M., Frasoldati, A., Hegedüs, L. (2016). Ultrasonic Imaging of the Thyroid Gland. In: Wartofsky, L., Van Nostrand, D. (eds) Thyroid Cancer. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-3314-3_23

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  • DOI: https://doi.org/10.1007/978-1-4939-3314-3_23

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