EXAM #1: IMAGING OF THE THYROID Flashcards

1
Q

In the normal individual, what happens to the thyorid gland with age?

A

Gland naturally becomes more nodular

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2
Q

Why would you image the thyroid gland?

A

1) Evaluate abnormality of thyroid function test

2) Morphologic abnormality

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3
Q

What is the role of imaging in hypothyroidism?

A

NONE

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4
Q

What test should I order for the hyperthyroid patient?

A

Nuclear medicine iodine uptake and scan

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5
Q

What type of rays are given off from the decay of the radioactive iodide?

A

Gamma rays

*These are in the same spectrum as x-rays i.e. a gamma camera

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6
Q

What determines whether a nuclear scan is normal or not?

A

Uptake of radioactive iodine

10-25% uptake is normal

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7
Q

What is the gross appearance of the thyroid in Graves’ Disease?

A

Large, beefy, symmetric, and red

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8
Q

What is the classic nuclear scan finding in Graves’ Disease?

A

Elevated uptake

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9
Q

What is the nuclear med finding in a toxic adenoma?

A
  • Normal range uptake

- BUT a very strong focus of activity

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10
Q

How will a multinodular goiter appear on nuclear scan?

A
  • Heterogenous
  • Many areas of focal uptake
  • Total uptake can be in the normal range
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11
Q

How will the nuclear med scan appear in the setting of thyroiditis?

A

*LOW uptake–looks like nothing

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12
Q

What is the difference between a goiter and a thyroid nodule?

A

Goiter= prominent thyroid gland

Nodule= single spot that is enlarged

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13
Q

In general, it is more high yield to image a diffuse enlargement of the thyroid vs. focal nodule?

A

Focal nodule

*Goiter/ diffuse enlargement is rarely associated with cancer

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14
Q

What are the three etiologies for a distinct thyroid nodule?

A

1) Cyst
2) Benign adenoma
3) Malignancy

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15
Q

What test is best to evaluate morphologic disease of thyroid?

A

Ultrasound

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16
Q

What kind of radiation is associated with US?

A

NON-ionizing radiation

*Electrons won’t be liberated; can’t cause DNA damage

17
Q

What is the major limitation of thyroid US?

A

No way to distinguish between benign and malignant

18
Q

How are nodules evaluated following US?

A

FNA