The thyroid is butterfly or "H"-shaped and composed of two lobes, each with a superior and inferior pole. Usually, the superior pole is narrower than the inferior pole, giving each lateral lobe a pear-like shape.
Goiter (rarely thyromegaly) refers to enlargement of the thyroid gland. It can occur from multiple conditions, including iodine deficiency, hormonal dyscrasias, and infectious/inflammatory conditions.
The American Thyroid Association (ATA) guidelines for assessment of thyroid nodules are meant to improve inter- and intra-reader consistency during assessment of thyroid nodules on ultrasound and to facilitate communication with referring endocrinologists.
liver span: <15 cm lymph nodes (all measurements are of short axis) mediastinal: <10 mm retrocrural: <6 mm hepatogastric ligament: < 8 mm porta hepatis: <6 mm celiac and mesenteric (preaortic), pancreaticoduodenal, perisplenic, mesenteric, retroperitoneal: <10 mm in short axis pelvic: < 15 mm ovarian follicle: <2.5-3 cm ovaries: volume ...
This article covers an approach to interpreting ultrasound of thyroid nodules, largely to determine whether an FNA is required. However, please note that several professional societies have published formal assessment criteria to determine the need for FNA, which are covered in separate articles.
Thyroid atrophy can arise in a number of situations and most with certain chronic thyroiditides such as: Hashimoto thyroiditis atrophic thyroiditis 1 It can also occur with conditions such as: irradiation prior treatment (e.g. I-131) of hyperactive conditions such as Graves disease 3 primary idiopathic hypothyroidism with thyroid atrophy
The enlarged thyroid may present as a midline neck swelling that moves on swallowing. Asymmetry may suggest nodularity. Tracheal deviation may also be noted. The mass may be diffusely enlarged with hyperthyroidism (Graves / thyroiditis) or normal function (colloid, goiter or iodine deficiency).
This uses a standardized scoring system for reports providing users with recommendations for when to use fine needle aspiration (FNA) or ultrasound follow-up of suspicious nodules, and when to safely leave alone nodules that are benign/not suspicious.
With the finding of a thyroid nodule >1 cm, a serum thyroid-stimulating hormone (TSH, thyrotropin) level should also be obtained. If the level is low, a radionuclide thyroid scan should be obtained.
The Society of Radiologists in Ultrasound (SRU) guidelines for assessment of thyroid nodules were defined in a consensus conference statement published in 2005 1 focused on which thyroid nodules detected on ultrasonography should undergo fine needle aspiration.
