Thyroid Ultrasound

Definition

Thyroid ultrasound is an imaging technique used for diagnosing suspected thyroid disease. It uses harmless, high-frequency sound waves to form an image. The sound waves are reflected by thyroid tissue to form a picture of internal structures. It is not invasive and involves no radiation.

Purpose

The thyroid gland is an organ located in front of the neck. It plays an important role in controlling the body's metabolism. Most thyroid ultrasounds are performed to evaluate a small lump (nodule) in the thyroid found during a physical examination or found by a radionuclide study (thyroid scan). The ultrasound can establish if the nodule is a cyst, which is an abnormal lump that contains fluid, or a solid mass. Cysts are almost always non-cancerous (benign), although in some cases the fluid may be taken out for additional testing.

If there are several masses or nodules, this indicates the presence of enlargement of the thyroid gland (goiter). If there is only one mass, it may be cancerous and needs further evaluation. Specialized thyroid ultrasounds, such as color Doppler flow studies, can add valuable information. By showing an image of the blood circulation in the gland, this study can assess some ambiguous masses in greater detail, to further refine diagnosis. In some cases, a needle will be inserted to remove some tissue from the mass for evaluation in a laboratory (needle biopsy). Ultra-sound is used during this procedure to help the physician guide the needle to the mass that needs to be evaluated.

Thyroid ultrasound can measure the size of the thyroid with great precision. Ultrasound studies may be done periodically to assess the response of the thyroid gland to medical therapy. An enlarged gland or a benign nodule should decrease in size when appropriate thyroid medication is taken.

Patients who have received therapeutic radiation to the head or neck may be monitored at regular intervals using thyroid ultrasound. The radiation puts these patients at higher risk for developing thyroid cancer or other abnormalities. In the early stages, these conditions may not cause symptoms or be apparent during a physical examination. They can, however, be detected by ultrasound.

Certain invasive medical procedures may be performed under ultrasound guidance. This is because ultra-sound allows the physician to observe a needle as it enters body tissue below the skin. This is useful to direct the removal of fluid from a cyst (aspiration) or needle biopsy. Medications to treat recurrent cysts may be administered directly to the area using ultrasound guidance.

Precautions

Thyroid ultrasound is safe for people of all ages. It is the preferred procedure to evaluate suspected disease in pregnant women because no radiation is involved.

Description

The study may be done in an outpatient facility or in a hospital department. The patient lies on his or her back. A pillow or rolled towel is placed under the shoulders and upper back, allowing the head to tilt back (hyperextend). A gel that enhances sound transmission is spread over the thyroid area. The technologist then gently places a transducer, an instrument about the size of an electric shaver, against the skin. It is moved over the thyroid area. The images from reflected sound waves appear on a monitor screen. There is no discomfort involved with this study. The examination takes 15–30 minutes.

Preparation

Some facilities recommend limiting food and drink for one hour before the study to prevent discomfort. No other preparation is needed.

Aftercare

No special restrictions or procedures are needed after a thyroid ultrasound.

Risks

There are no risks with this procedure.

Normal results

A normal study would reveal a thyroid gland of normal size, shape, position, and uniform texture.

Abnormal results

A thyroid ultrasound may reveal cysts, solid masses that may or may not be cancerous, or an enlarged thyroid gland (goiter). In many cases, the ultrasound can establish a diagnosis. Sometimes the information revealed will need to be combined with data from other studies to determine the problem.

PERIODICALS

Rifat, Sami F., and Mack T. Ruffin. "Management of Thyroid Nodules." American Family Physician 50 (15 Sept. 1994): 785-791.

Ellen S. Weber, MSN