Thyroid Ultrasonography and Fine Needle Aspiration Biopsy: A Practical Guide and Picture Atlas

Ultrasound of the Normal Thyroid Gland

Author(s): Samer El-Kaissi and Jack R Wall

Pp: 10-15 (6)

DOI: 10.2174/9781681086859118010004

* (Excluding Mailing and Handling)

Abstract

Thyroid ultrasound is used in clinical practice to assess thyroid gland volume and vascularity, assess thyroid nodules and cervical lymph nodes, examine the parathyroid glands in patients with primary hyperparathyroidism, guide biopsies, aspiration and ablation of thyroid and anterior neck structures, and in post-operative thyroid cancer surveillance. However, thyroid ultrasound is not suitable as a screening tool of the thyroid. Ultrasound examination of the thyroid follows a systematic approach beginning with the thyroid gland volume, echogenicity, echotexture, Doppler flow and a detailed examination of any thyroid nodules. This is followed by an examination of the anterior neck cervical lymph nodes, and the parathyroid glands if clinically indicated. The normal thyroid gland is echogenic compared to the neck muscles and displays little or no vascularity on Doppler study. The size of a normal thyroid gland is 4-6 cm in length, 1.3-1.8 cm anteroposteriorly, and the isthmus width is less than 6 mm. The thyroid ultrasound report should provide information about the examination technique, a brief summary of the indications for the ultrasound, detailed findings of the examination, conclusions and management recommendations.


Keywords: Cervical lymph nodes, Doppler, Echogenicity, Echotexture, Indications, Microbubble contrast, Margins, Nodule, Retrosternal goitre, Thyroid, Thyroid ultrasound reporting, Thyroid volume, Transducer, Ultrasound, Ultrasound elastography.

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      • 13. app/Models/UserAccess/UserAccess.php:1266
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      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Trial Access" as access_base_text, CASE j.type WHEN 111 THEN true ELSE false END as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_trail` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 59854122 and j.to_ip >=59854122 )) and ((j.from_date <= 1740775219 and j.to_date >= 1740775219 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 12813) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Subscribed" as access_base_text, false as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_corporate` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 59854122 and j.to_ip >=59854122 )) and ((j.from_date <= 1740775219 and j.to_date >= 1740775219 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 12813) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Token Based Access" as access_base_text, false as terms_popup, "R" as content_download_type, j.uc_id as restricted_user_access_key, "v" as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_token` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 59854122 and j.to_ip >=59854122 )) and ((j.from_date <= 1740775219 and j.to_date >= 1740775219 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 12813)
      890μsalphaeurekaselec_live_10_06_2022UserAccess.php#1266
      Backtrace
      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1549
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • select b.banner_link, b.banner_name, b.banner_script, b.banner_remarks, b.banner_file_name, b.banner_placement, bd.content_type, bd.content_id from `tbl_banner` as `b` inner join `tbl_banner_detail` as `bd` on `bd`.`banner_id` = `b`.`banner_id` inner join `users` as `u` on `u`.`id` = `b`.`updated_by` where `b`.`banner_ebook` = 1 and `bd`.`content_type` = 'B' and `bd`.`content_id` = 2636 and `b`.`banner_from_date` <= 1740775219 and `b`.`banner_to_date` >= 1740775219 and `b`.`banner_status` = 'A' order by `b`.`banner_id` desc
      1.44msalphaeurekaselec_live_10_06_2022Banner.php#95
      Bindings
      • 0: 1
      • 1: B
      • 2: 2636
      • 3: 1740775219
      • 4: 1740775219
      • 5: A
      Backtrace
      • 13. app/Models/Banner.php:95
      • 14. app/Http/helpers.php:404
      • 17. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 18. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    • select count(*) as aggregate from `uc_cart_products` where cart_id='7faa4280e65a73cbb9cad5a9f4ea3af7'
      9msalphaeurekaselec_live_10_06_2022Cart.php#271
      Backtrace
      • 15. app/Models/Cart.php:271
      • 16. view::layouts._header:291
      • 18. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 20. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    App\Models\Keywords
    15Keywords.php#?
    App\Models\Chapter
    1Chapter.php#?
    App\Models\Ebook
    1Ebook.php#?
        _token
        6Qie1vLpQ4x2kOhxHsJApJwvhvr4efLQAyxXU0sH
        uc_cart_id
        7faa4280e65a73cbb9cad5a9f4ea3af7
        _previous
        array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/12813" ]
        _flash
        array:2 [ "old" => [] "new" => [] ]
        PHPDEBUGBAR_STACK_DATA
        []
        path_info
        /chapter/12813
        status_code
        200
        
        status_text
        OK
        format
        html
        content_type
        text/html; charset=UTF-8
        request_query
        []
        
        request_request
        []
        
        request_headers
        0 of 0
        array:17 [ "x-https" => array:1 [ 0 => "1" ] "host" => array:1 [ 0 => "alpha.eurekaselect.com" ] "priority" => array:1 [ 0 => "u=0, i" ] "cookie" => array:1 [ 0 => "wayfindertarget=eyJpdiI6Ilh3a1pVNnBFdnpTRFlHbk5SaUZ2dlE9PSIsInZhbHVlIjoialFxQ2tKcmcvbTJwazcwcW9yVW9CaTRteEJSWVlkNTNxMXRyUjI0VnNvZz0iLCJtYWMiOiI2YzljMGYwMGYyYTFiY2Q5OGFiMzM3MDdjNWJkYWRlZTFlMWMwNmVmYTRkMWNiOTY2NmIzMTkzNGYzMjNjYzU5IiwidGFnIjoiIn0%3Dwayfindertarget=eyJpdiI6Ilh3a1pVNnBFdnpTRFlHbk5SaUZ2dlE9PSIsInZhbHVlIjoialFxQ2tKcmcvbTJwazcwcW9yVW9CaTRteEJSWVlkNTNxMXRyUjI0VnNvZz0iLCJtYWMiOiI2YzljMGYwMGYyYTFi" ] "accept-encoding" => array:1 [ 0 => "gzip, deflate, br, zstd" ] "sec-fetch-dest" => array:1 [ 0 => "document" ] "sec-fetch-user" => array:1 [ 0 => "?1" ] "sec-fetch-mode" => array:1 [ 0 => "navigate" ] "sec-fetch-site" => array:1 [ 0 => "none" ] "accept" => array:1 [ 0 => "text/html,application/xhtml+xml,application/xml;q=0.9,image/avif,image/webp,image/apng,*/*;q=0.8,application/signed-exchange;v=b3;q=0.7" ] "user-agent" => array:1 [ 0 => "Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)" ] "upgrade-insecure-requests" => array:1 [ 0 => "1" ] "sec-ch-ua-platform" => array:1 [ 0 => ""Windows"" ] "sec-ch-ua-mobile" => array:1 [ 0 => "?0" ] "sec-ch-ua" => array:1 [ 0 => ""HeadlessChrome";v="129", "Not=A?Brand";v="8", "Chromium";v="129"" ] "cache-control" => array:1 [ 0 => "no-cache" ] "pragma" => array:1 [ 0 => "no-cache" ] ]
        request_cookies
        0 of 0
        array:1 [ "wayfindertarget" => null ]
        response_headers
        0 of 0
        array:5 [ "content-type" => array:1 [ 0 => "text/html; charset=UTF-8" ] "cache-control" => array:1 [ 0 => "no-cache, private" ] "date" => array:1 [ 0 => "Fri, 28 Feb 2025 20:40:19 GMT" ] "set-cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6InB6Qzh1VFprRnNKeThENXdaK052a2c9PSIsInZhbHVlIjoiU0UxMjgzd1VWNTFyWDFqWDNOZXRCdGs0QjhQcUVaMmJ1WHF6d0JIKzF5S2o3M3BOSDBNenFTRGl0M0VYR2RVS1FuZGFObDMyTTZVU1JVdjdlZjFRUjdTbGF2MWtRMlRwU1pLR2l3Kys1VCtRYll0YkdzS0RmQTRQT1ZGdWZHNngiLCJtYWMiOiI1YjUyNmRmM2YyMjE2YjlkNzUyNDVkMTA5M2ZjOWYxNWU1ODNjNDk5NjM1MDRmOTJkY2Q3NjkwYTZmZTRhYjIxIiwidGFnIjoiIn0%3D; expires=Mon, 03 Mar 2025 08:40:19 GMT; Max-Age=216000; path=/; secure; samesite=laxXSRF-TOKEN=eyJpdiI6InB6Qzh1VFprRnNKeThENXdaK052a2c9PSIsInZhbHVlIjoiU0UxMjgzd1VWNTFyWDFqWDNOZXRCdGs0QjhQcUVaMmJ1WHF6d0JIKzF5S2o3M3BOSDBNenFTRGl0M0VYR2RVS1FuZGFOb" 1 => "alphaeurekaselectnet_session=eyJpdiI6IlFmSHprV083UE0rek1Pd0Y2MlNCSUE9PSIsInZhbHVlIjoidEJCUXpGT1Q0SEZLVHdsOW1razVPZXB0ZmxjYmp5Z3BZb2JiUXRSNWZIOE1OZksyeDN5ejNmUTAvVVEvN1dob1JIdVFxamkxbnl1NitlSk1MOWVzL2VRS2NuYWNOMW5uT0c3YTBhN0RTL2srd2tXSVhqU2xKRjNoYjcwSjkyVlUiLCJtYWMiOiIyYWVkNDU5MDZmMzg4MmU0YzVmMGZlYWQxNDAwMzhkYzhjNmFkMTVlMjM1ZGFiYTY0NzE3NzM2YmUyYzFkODdlIiwidGFnIjoiIn0%3D; path=/; secure; httponly; samesite=laxalphaeurekaselectnet_session=eyJpdiI6IlFmSHprV083UE0rek1Pd0Y2MlNCSUE9PSIsInZhbHVlIjoidEJCUXpGT1Q0SEZLVHdsOW1razVPZXB0ZmxjYmp5Z3BZb2JiUXRSNWZIOE1OZksyeDN5ejNmUTA" ] "Set-Cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6InB6Qzh1VFprRnNKeThENXdaK052a2c9PSIsInZhbHVlIjoiU0UxMjgzd1VWNTFyWDFqWDNOZXRCdGs0QjhQcUVaMmJ1WHF6d0JIKzF5S2o3M3BOSDBNenFTRGl0M0VYR2RVS1FuZGFObDMyTTZVU1JVdjdlZjFRUjdTbGF2MWtRMlRwU1pLR2l3Kys1VCtRYll0YkdzS0RmQTRQT1ZGdWZHNngiLCJtYWMiOiI1YjUyNmRmM2YyMjE2YjlkNzUyNDVkMTA5M2ZjOWYxNWU1ODNjNDk5NjM1MDRmOTJkY2Q3NjkwYTZmZTRhYjIxIiwidGFnIjoiIn0%3D; expires=Mon, 03-Mar-2025 08:40:19 GMT; path=/; secureXSRF-TOKEN=eyJpdiI6InB6Qzh1VFprRnNKeThENXdaK052a2c9PSIsInZhbHVlIjoiU0UxMjgzd1VWNTFyWDFqWDNOZXRCdGs0QjhQcUVaMmJ1WHF6d0JIKzF5S2o3M3BOSDBNenFTRGl0M0VYR2RVS1FuZGFOb" 1 => "alphaeurekaselectnet_session=eyJpdiI6IlFmSHprV083UE0rek1Pd0Y2MlNCSUE9PSIsInZhbHVlIjoidEJCUXpGT1Q0SEZLVHdsOW1razVPZXB0ZmxjYmp5Z3BZb2JiUXRSNWZIOE1OZksyeDN5ejNmUTAvVVEvN1dob1JIdVFxamkxbnl1NitlSk1MOWVzL2VRS2NuYWNOMW5uT0c3YTBhN0RTL2srd2tXSVhqU2xKRjNoYjcwSjkyVlUiLCJtYWMiOiIyYWVkNDU5MDZmMzg4MmU0YzVmMGZlYWQxNDAwMzhkYzhjNmFkMTVlMjM1ZGFiYTY0NzE3NzM2YmUyYzFkODdlIiwidGFnIjoiIn0%3D; path=/; secure; httponlyalphaeurekaselectnet_session=eyJpdiI6IlFmSHprV083UE0rek1Pd0Y2MlNCSUE9PSIsInZhbHVlIjoidEJCUXpGT1Q0SEZLVHdsOW1razVPZXB0ZmxjYmp5Z3BZb2JiUXRSNWZIOE1OZksyeDN5ejNmUTA" ] ]
        session_attributes
        0 of 0
        array:5 [ "_token" => "6Qie1vLpQ4x2kOhxHsJApJwvhvr4efLQAyxXU0sH" "uc_cart_id" => "7faa4280e65a73cbb9cad5a9f4ea3af7" "_previous" => array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/12813" ] "_flash" => array:2 [ "old" => [] "new" => [] ] "PHPDEBUGBAR_STACK_DATA" => [] ]
        ClearShow all
        Date ↕MethodURLData
        #12025-02-28 20:40:19GET/chapter/128131121917