Toxic multinodular goiter echocardiography or ultrasound: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Toxic multinodular goiter}} | {{Toxic multinodular goiter}} | ||
{{CMG}}; {{AE}} | {{CMG}}; {{AE}} {{Mazia}} | ||
==Overview== | ==Overview== | ||
Thyroid ultrasonography is the imaging method of choice in the diagnosis of multinodular goiter. | [[Thyroid]] ultrasonography is the imaging method of choice in the diagnosis of multinodular goiter. Findings on an [[ultrasonography]] suggestive of multinodular goiter include more than one [[nodule]] including the non-palpable nodules cysts with varying [[echogenicity]]. | ||
Findings on an ultrasonography suggestive of multinodular goiter include more than one nodule including the non-palpable nodules cysts with varying echogenicity. | Thyroid ultrasonography helps in assessment of size and number of [[nodules]]. Assessment of vascular characteristics of a [[thyroid nodule]] with [[Doppler ultrasound|Doppler]] helps in screening [[Thyroid nodule|thyroid nodules]] for [[malignancy]]. | ||
Thyroid ultrasonography helps in assessment of size and number of nodules.Assessment of vascular characteristics of a thyroid nodule with Doppler helps in screening thyroid nodules for malignancy. | |||
==Ultrasound== | ==Ultrasound== | ||
*Thyroid ultrasonography is the imaging method of choice in the diagnosis of multinodular goiter. | *[[Thyroid]] [[ultrasonography]] is the imaging method of choice in the diagnosis of multinodular goiter. | ||
*Findings on an ultrasonography suggestive of multinodular goiter include more than one nodule including the non-palpable nodules cysts with varying echogenicity. | *Findings on an ultrasonography suggestive of multinodular goiter include more than one [[nodule]] including the non-palpable nodules cysts with varying [[echogenicity]].<ref name="pmid27741354">{{cite journal |vauthors=Haugen BR |title=2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: What is new and what has changed? |journal=Cancer |volume=123 |issue=3 |pages=372–381 |year=2017 |pmid=27741354 |doi=10.1002/cncr.30360 |url=}}</ref> | ||
*Thyroid ultrasonography helps in assessment of size and number of nodules. Surgeon-performed ultrasonographic examinations can be used to make necessary changes in surgical treatment and to avoid unnecessary surgery.<ref name="pmid20135315">{{cite journal |vauthors=Mazzaglia PJ |title=Surgeon-performed ultrasound in patients referred for thyroid disease improves patient care by minimizing performance of unnecessary procedures and optimizing surgical treatment |journal=World J Surg |volume=34 |issue=6 |pages=1164–70 |year=2010 |pmid=20135315 |doi=10.1007/s00268-010-0402-y |url=}}</ref> | *[[Thyroid]] [[ultrasonography]] helps in assessment of size and number of [[nodules]]. Surgeon-performed ultrasonographic examinations can be used to make necessary changes in surgical treatment and to avoid unnecessary surgery.<ref name="pmid20135315">{{cite journal |vauthors=Mazzaglia PJ |title=Surgeon-performed ultrasound in patients referred for thyroid disease improves patient care by minimizing performance of unnecessary procedures and optimizing surgical treatment |journal=World J Surg |volume=34 |issue=6 |pages=1164–70 |year=2010 |pmid=20135315 |doi=10.1007/s00268-010-0402-y |url=}}</ref> | ||
*Assessment of vascular characteristics of a thyroid nodule with Doppler helps in screening thyroid nodules for malignancy. | *Assessment of [[vascular]] characteristics of a [[thyroid nodule]] with [[Doppler]] helps in screening [[Thyroid nodule|thyroid nodules]] for [[malignancy]]. | ||
*Findings on ultrasonography suggestive of multinodular goiter benign nodules include:<ref name="pmid21543434">{{cite journal |vauthors=Bahn RS, Castro MR |title=Approach to the patient with nontoxic multinodular goiter |journal=J. Clin. Endocrinol. Metab. |volume=96 |issue=5 |pages=1202–12 |year=2011 |pmid=21543434 |doi=10.1210/jc.2010-2583 |url=}}</ref> | *Findings on [[ultrasonography]] suggestive of multinodular goiter [[benign]] nodules include:<ref name="pmid21543434">{{cite journal |vauthors=Bahn RS, Castro MR |title=Approach to the patient with nontoxic multinodular goiter |journal=J. Clin. Endocrinol. Metab. |volume=96 |issue=5 |pages=1202–12 |year=2011 |pmid=21543434 |doi=10.1210/jc.2010-2583 |url=}}</ref> | ||
**Iso-hyperechoic nodules | **Iso-hyperechoic nodules | ||
**Surrounding hypoechoic halo | **Surrounding hypoechoic halo | ||
**Spongelike/honeycomb pattern | **Spongelike/honeycomb pattern | ||
**Peripheral (eggshell) or coarse calcifications. | **Peripheral (eggshell) or coarse calcifications. | ||
**Doppler: | **[[Doppler]]: | ||
***Peripheral vessels are usually noted | ***Peripheral vessels are usually noted | ||
***The risk of malignancy is lower in nodules with a predominantly perinodular pattern | ***The risk of [[malignancy]] is lower in nodules with a predominantly perinodular pattern | ||
*Findings on ultrasonography suggestive of multinodular goiter malignant nodules include:<ref name="pmid21543434">{{cite journal |vauthors=Bahn RS, Castro MR |title=Approach to the patient with nontoxic multinodular goiter |journal=J. Clin. Endocrinol. Metab. |volume=96 |issue=5 |pages=1202–12 |year=2011 |pmid=21543434 |doi=10.1210/jc.2010-2583 |url=}}</ref> | *Findings on [[ultrasonography]] suggestive of multinodular goiter malignant nodules include:<ref name="pmid21543434">{{cite journal |vauthors=Bahn RS, Castro MR |title=Approach to the patient with nontoxic multinodular goiter |journal=J. Clin. Endocrinol. Metab. |volume=96 |issue=5 |pages=1202–12 |year=2011 |pmid=21543434 |doi=10.1210/jc.2010-2583 |url=}}</ref> | ||
**Hypoechoic solid | **Hypoechoic solid | ||
**Intranodular blood flow. | **Intranodular blood flow. | ||
**Presence of microcalcifications | **Presence of [[Microcalcification|microcalcifications]] | ||
**Size greater than 10mm | **Size greater than 10mm | ||
** | **[[Nodules]] with an exclusively central vascular pattern on [[doppler]] | ||
*It is important to screen for presence of malignant features (if any) and futher investigate with fine needle aspiration biopsy(FNAB) from the suspicious nodule. | *It is important to screen for presence of malignant features (if any) and futher investigate with [[Needle aspiration biopsy|fine needle aspiration biopsy]](FNAB) from the suspicious nodule. | ||
*Thyroid ultrasonography can be used to guide FNAB. ultrasonography-guided FNAB may be preferable to palpation-guided FNAB. | *[[Thyroid]] [[ultrasonography]] can be used to guide FNAB. ultrasonography-guided FNAB may be preferable to palpation-guided FNAB. | ||
*The possibility of measuring thyroid volume is another highly useful feature of ultrasonographic studies particularly after therapy with L-T4 or radioiodine ablation | *The possibility of measuring thyroid volume is another highly useful feature of ultrasonographic studies particularly after therapy with L-T4 or [[Radioiodine|radioiodine ablation]] | ||
[[Image:Multinodular-goitre-2.jpg|200px|thumb|left|uyfyitfiytfiy; <small>Courtesy:Case courtesy of Dr Nikola Todorovic, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/53204">rID: 53204</a></small>]] | |||
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==References== | ==References== | ||
Latest revision as of 14:00, 13 October 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mazia Fatima, MBBS [2]
Overview
Thyroid ultrasonography is the imaging method of choice in the diagnosis of multinodular goiter. Findings on an ultrasonography suggestive of multinodular goiter include more than one nodule including the non-palpable nodules cysts with varying echogenicity. Thyroid ultrasonography helps in assessment of size and number of nodules. Assessment of vascular characteristics of a thyroid nodule with Doppler helps in screening thyroid nodules for malignancy.
Ultrasound
- Thyroid ultrasonography is the imaging method of choice in the diagnosis of multinodular goiter.
- Findings on an ultrasonography suggestive of multinodular goiter include more than one nodule including the non-palpable nodules cysts with varying echogenicity.[1]
- Thyroid ultrasonography helps in assessment of size and number of nodules. Surgeon-performed ultrasonographic examinations can be used to make necessary changes in surgical treatment and to avoid unnecessary surgery.[2]
- Assessment of vascular characteristics of a thyroid nodule with Doppler helps in screening thyroid nodules for malignancy.
- Findings on ultrasonography suggestive of multinodular goiter benign nodules include:[3]
- Iso-hyperechoic nodules
- Surrounding hypoechoic halo
- Spongelike/honeycomb pattern
- Peripheral (eggshell) or coarse calcifications.
- Doppler:
- Peripheral vessels are usually noted
- The risk of malignancy is lower in nodules with a predominantly perinodular pattern
- Findings on ultrasonography suggestive of multinodular goiter malignant nodules include:[3]
- Hypoechoic solid
- Intranodular blood flow.
- Presence of microcalcifications
- Size greater than 10mm
- Nodules with an exclusively central vascular pattern on doppler
- It is important to screen for presence of malignant features (if any) and futher investigate with fine needle aspiration biopsy(FNAB) from the suspicious nodule.
- Thyroid ultrasonography can be used to guide FNAB. ultrasonography-guided FNAB may be preferable to palpation-guided FNAB.
- The possibility of measuring thyroid volume is another highly useful feature of ultrasonographic studies particularly after therapy with L-T4 or radioiodine ablation
References
- ↑ Haugen BR (2017). "2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: What is new and what has changed?". Cancer. 123 (3): 372–381. doi:10.1002/cncr.30360. PMID 27741354.
- ↑ Mazzaglia PJ (2010). "Surgeon-performed ultrasound in patients referred for thyroid disease improves patient care by minimizing performance of unnecessary procedures and optimizing surgical treatment". World J Surg. 34 (6): 1164–70. doi:10.1007/s00268-010-0402-y. PMID 20135315.
- ↑ 3.0 3.1 Bahn RS, Castro MR (2011). "Approach to the patient with nontoxic multinodular goiter". J. Clin. Endocrinol. Metab. 96 (5): 1202–12. doi:10.1210/jc.2010-2583. PMID 21543434.