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Thyroid disorders are common and include many entities. They can be symptomatic, asymptomatic, diffuse, focal, neoplastic, or non-neoplastic processes.Neck ultrasound (US), with the prospect of proceeding to fine needle aspiration (FNA), is the first line of investigation; however, other options are available.
Ultrasound is the preferred imaging modality for thyroid tumors and lesions, and its use is important in the evaluation, preoperative planning, and postoperative surveillance of patients with thyroid cancer. Many other benign and malignant conditions in the head and neck can be differentiated, evaluated, and managed with the help of diagnostic ...
TSH – A thyroid-stimulating hormone level should be obtained first. If it is suppressed, then the nodule is likely a hyperfunctioning (or "hot") nodule. These are rarely malignant. FNAC – fine needle aspiration cytology is the investigation of choice given a non-suppressed TSH. [27] [28] Imaging – Ultrasound and radioiodine scanning.
An ARFI image of a thyroid nodule in the right thyroid lobe. The shear wave speed inside the box is 6.24 m/s, which is reflective of a high stiffness. Histology revealed papillary carcinoma. Acoustic radiation force impulse imaging (ARFI) [5] uses ultrasound to create a qualitative 2-D
Ultrasound imaging of the thyroid showing Hashimoto's thyroiditis. An ultrasound may be useful in detecting Hashimoto thyroiditis, especially in those with seronegative thyroiditis, [15] or when patients have normal laboratory values but symptoms of autoimmune thyroiditis. [52]
The patient swallows a radioisotope of iodine in the form of capsule or fluid, and the absorption (uptake) of this radiotracer by the thyroid is studied after 4–6 hours and after 24 hours with the aid of a scintillation counter. The dose is typically 0.15–0.37 MBq (4–10 μCi) of 131 I iodide, or 3.7–7.4 MBq (100–200 μCi) of 123 I ...
SPECT (three-dimensional) imaging, as an adjunct to planar methods, may increase sensitivity and accuracy, [2] especially in cases of small parathymic adenomas. By using a gamma camera in nuclear medicine, the radiologist is able to determine if one of the four parathyroid glands is hyperfunctioning, if that is the cause of the hyperparathyroidism.
The ultrasound may also locate nodules that are too small for a doctor to feel on a physical exam, and can demonstrate whether a nodule is primarily solid, liquid , or a mixture of both. It is an imaging process that can often be done in a doctor's office, is painless, and does not expose the individual to any radiation. [29]