Ultrasound signs of thyroid disease

Thyroid diseases are the second most common endocrinological pathology. It is the thyroid gland that is one of the most susceptible & nbsp; to the effects of radioactive radiation of organs, and in our country this problem is especially relevant. If a thyroid pathology is suspected, the first and most important diagnostic method is an ultrasound examination of the thyroid gland. Each practitioner should be aware of the indications and methodology for conducting this study, as well as be able to correctly interpret the results. It is the competence of the doctor that determines the prognosis for the life and work capacity of a patient with thyroid pathology.

Indications for thyroid ultrasound

Today, with the slightest disturbance in the functioning or appearance of the thyroid gland, the patient is sent for an ultrasound examination.  However, there are clear recommendations in which specific cases an ultrasound examination of the thyroid gland is justified:

• palpation detection of formations in the thyroid gland;
• visually large formations in the neck area;
• monitoring the effectiveness of the results of the treatment;
• observation of patients after surgical interventions on the thyroid gland;
• ultrasound monitoring during thyroid biopsy;
• Prevention studies in iodine-deficient regions.

Thyroid ultrasound procedure

During the examination, the patient lies on his back with a roller placed under his shoulders and his head thrown back high. The ultrasonic sensor is carried out along the anatomical site on the neck from the thyroid cartilage to the supraclavicular regions.  During an ultrasound examination of the thyroid gland, it is necessary to evaluate its following signs: location, size, contours, echo structure, echogenicity, the presence of volumetric formations and their qualitative characteristics, the relationship of the thyroid gland with surrounding tissues, the state of regional lymph nodes. The normal state of the thyroid gland is characterized by its typical location, clear and even contours, moderate echogenicity, homogeneous or heterogeneous echo structure.

Ultrasound signs of diffuse non-toxic goiter and autoimmune thyroid diseases

With diffuse non-toxic goiter, the normal structure of the thyroid gland of medium echogenicity is preserved, its smooth and clear contours. Focal changes are often found, which are visualized as small hypo- or anechoic zones. Diffuse toxic goiter and chronic autoimmune thyroiditis are autoimmune  diseases of the thyroid gland, and their main ultrasound sign is a diffuse or focal change in echogenicity. Ultrasound signs of diffuse toxic goiter are a significant increase in the volume of the thyroid gland, with the size increased diffusely, its smooth and clear contours, heterogeneous echo structure, moderately reduced echogenicity. Autoimmune chronic thyroiditis tends to occur in two variants: hypertrophic and atrophic. In the hypertrophic variant of autoimmune thyroiditis, a pronounced decrease in echogenicity and a heterogeneous structure of the thyroid gland are observed. The atrophic variant is characterized by hypoechoic areas against the background of increased echogenicity, while the atrophied thyroid gland is significantly reduced in size.

Ultrasound signs of acute and subacute thyroiditis

In acute purulent thyroiditis, the entire thyroid gland, or only one of its lobes, may be involved in the pathological process. Ultrasound signs of acute thyroiditis are & nbsp; an increase in the size of the lobes of the thyroid gland and the appearance of zones of significantly reduced echogenicity without clear contours. Subacute thyroiditis is characterized by the following ultrasound signs: an increase in the size of the thyroid gland, the presence of its fuzzy contours, a heterogeneous structure, the appearance of hypo- and anechoic zones. With a total lesion of the gland, it becomes hypoechoic. In the first few weeks of the disease, small paratracheal lymph nodes are determined, which cease to be visualized after the start of therapy.

Ultrasound signs of nodular and multinodular goiter

For  multinodular goiter is characterized by the visualization of multiple formations with well-defined contours. Echogenicity in this case can be completely different, the structure of the thyroid gland can be solid or combined with anechoic zones. Often you can see hyperechoic inclusions, which are characterized by an acoustic shadow, due to the presence of calcifications. Some nodes may be surrounded by a hypoechoic rim, which may correspond to a capsule, an inflammatory process, or swelling of the thyroid gland. A multinodular goiter can be visualized on ultrasound as a  conglomerate of formations.

Ultrasound signs of thyroid neoplasms

Neoplasms of any nature in the thyroid gland during ultrasound examination are determined by formations of different sizes with clear contours, they can be round or oval in shape. Their echogenicity is often reduced, but may be medium or increased. There are no unambiguous ultrasound criteria by which it would be possible to distinguish a benign formation from a malignant one. There are such echographic signs that can be used to suspect the malignant nature of the formation:

• education outlines are fuzzy, intermittent, uneven;
• solid character and low echogenicity of the mass;
• presence of microcalcifications;
• small calcifications  solitary node in young patients;
• the predominance of the tumor thickness over its width.

Remember that there are no reliable ultrasound signs to establish a diagnosis of a malignant process in the thyroid gland! Additional thyroid tests are needed to confirm cancer!