What imaging test should you have to understand if your thyroid has a disorder?
Ultrasound (U/S) is an integral tool in the evaluation of thyroid diseases.
Its widespread use is due to:
• safety
• low cost
• high accuracy
• Through this examination, it is possible to evaluate various pathological conditions, (e.g. thyroiditis, nodules, etc.
However, the reliability of the results depends significantly on the experience of the examiner and the use of modern high-definition machines.
Thyroid Ultrasound: a Safe and Effective Examination for the Evaluation of Nodules
Ultrasound allows the assessment of the size of the thyroid, the echogenicity of the parenchyma and the possible presence of nodules.
The patient is placed in a supine position with hyperextension of the neck, thus allowing better visualization of the thyroid and surrounding tissues.
Assessment of nodules should be done with the latest international assessment criteria.
The introduction of the ACR TI-RADS (American College of Radiology Thyroid Imaging Reporting and Data System) criteria allows the categorization of the risk of malignancy of nodules, providing a framework for the assessment and decision-making regarding the need for ultrasound-guided fine needle aspiration (FNA).
In summary, thyroid ultrasound is emerging as a reliable tool and a growing means for the detection and evaluation of nodules. The application of the ACR TI-RADS criteria offers consistency in the assessment of the risk of malignancy between radiologists and clinicians, making it an indispensable tool in daily clinical practice. practice.
When do we use ultrasound:
1. We use ultrasound for the initial assessment of the parenchyma, the possible presence of nodules and the evaluation of adjacent lymph nodes.
2. Ultrasound is used for the additional study of nodules with Elastography, which provides information about the hardness of the nodules and is a complementary tool that can help in the diagnosis between benign and malignant tissue.
3. Monitoring of multinodular goiter is done with ultrasound, as it allows monitoring of the progression of the goiter and any changes in the size of the nodules or in its characteristics.
4. Preoperative evaluation (neck mapping) in known thyroid carcinoma is done with ultrasound to assess the size of the cancer, the extension of the in surrounding tissues and the presence of possible metastases in the lymph nodes.
5. Postoperative evaluation of the neck after thyroidectomy is also performed with ultrasound to assess the possible presence of residual tissue or the presence of lymph nodes in any area or to have recurred after surgery.
6. Ultrasound is also used to guide the needle during the FNA, in order to facilitate the selection of an appropriate area for sampling.
