Thyroid lesions – evaluation with sonography

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Ultrasound diagnosis of thyroid gland lesions

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Thyroid lesions – evaluation with sonography

  1. 1. Thyroid lesions – Evaluation with Sonography Presented BY DR Laith Al hialy
  2. 2. thyroid disorders – presentation • • • • • thyroid gland enlargement (Goiter ) Palpable nodule Hyperthyroidism Hypothyroidism Cervical - LN
  3. 3. Imaging Approach for thyroid nodule 2 – institutions ways • US ( 7-10 MHZ liner – with Doppler study) • thyroid scintigraphy ( radionuclide Tc , 123 Iodine ) 99m • CT , MRI ( none palpable nodule ) • FNA Biopsy • Palpable Nodule > 1 cm direct biopsy • Nodule < 1 cm , Cyst also not appreciated
  4. 4. BY sonographic examination what we can detected ? • Mass ( nodule Solitary – multiple ) • Cyst • Calcification • Change in thyroid tissue texture • Cervical LN
  5. 5. Goiter could be presented as retrosternal upper mediastinal mass
  6. 6. Goiter could compress the trachea Before after thyroidectomy
  7. 7. Benign lesion 1. Cyst lesion Most common colloid cyst Anechoic , well defined , comet tail appearance 2. Hematoma happen with degenerative nodule
  8. 8. Benign lesion Nodule ( hyperplasic or adenomatous ) Well defined , smooth margin , texture echogenic –isoechoic , fine hypoechoic rim , curvilinear fine calcification with faint acoustic shadow , equivocal vascularity by Doppler, internal hemorrhage
  9. 9. Benign lesion Inflammatory condition Hashimoto’s Thyroiditis. typical sonographic features include: a diffusely enlarged gland demonstrating hypoechoic areas with a very disorganized and heterogeneous pattern
  10. 10. Malignant lesion Papillary carcinoma is the most common thyroid malignancy 75 % Follicular, Medullary and Aplastic carcinomas and lymphoma make up the remaining 25% Metastases from lung, breast, and colon cancers ill defined margin, hypoechoic and punctuate –micro calcifications ( psammomatous calcification) with acoustic shadow Hyper vascularity by Doppler Thick halo 1-2 mm , cervical LN
  11. 11. Malignant nodule NHL of thyroid
  12. 12. Thyroid nodule isotopes scan Hot nodule cold nodule

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