Lesson 1D

Question 1

What is the echogenicity of the thyroid gland?

Answer 1

Uniformly echogenic relative to the overlying strap muscles of the neck

Question 2

Thyroid nodules

Answer 2

As a region of parenchyma sonographically distinct from the remainder of the thyroid

Question 3

Where are thyroid nodules located?

Answer 3

Within the confines of the echogenic thyroid capsule

Question 4

How many dimensions should the size of the thyroid nodule be measured in when detected?

Answer 4

3

Question 5

What should happen if a thyroid nodule is detected? (2)

Answer 5

1. Size/measure
2. Location
   - upper pole, mid gland or lower pole

Question 6

What are some sonographic features for differential diagnosis? (6)

Answer 6

1. Nodule echogenicity
2. Morphology
3. Cystic change
4. Echogenic foci with comet-tail artifact representing colloid
5. Calcifications
6. Flow pattern
   - peripheral or central

Question 7

Comet tail artifact

Answer 7

Is a short path reverberation artefact that weakens with each reverberation, resulting in a vertical echogenic artefact that rapidly fades as it continues in to the ultrasound image

Question 8

Colloid cysts

Answer 8

Are benign cystic fluid collections that occur within the fluid-filled sacs that contain comet tail artifacts in them

Question 9

Simple cysts

Answer 9

Usually contains only fluid, and it is surrounded by a very thin wall
- not dangerous

Question 10

Hemorrhagic cysts

Answer 10

Is a functional cyst that occurs when bleeding occurs within a cyst

Question 11

Mural nodules

Answer 11

Nodules on a wall of a cysts

Question 12

What is the echogenicity of a thyroid carcinoma?

Answer 12

They are hypoechoic relative to the surrounding thyroid parenchyma

Question 13

What is not common in predominantly cystic nodules?

Answer 13

Thyroid cancer

Question 14

What can cysts contain? (4)

Answer 14

1. Serous fluid
2. Colloid
3. Old hemorrhage
4. Resultant echogenic fluid

Question 15

What are examples of nonuniform patterns of degeneration? (3)

Answer 15

1. Mural nodules
2. Septations
3. Internal debris

Question 16

What are assoicated with comet tail artifact?

Answer 16

Punctate echogenic foci

Question 17

What are comet tail artifacts?

Answer 17

Benign cystic nodules

Question 18

Where is calcification found? (3)

Answer 18

1. Papillary thyroid carcinomas
2. Medullary thyroid carcinomas
3. Anaplastic thyroid carcinomas

Question 19

What is the most specific sonographic feature associated with thyroid malignancy?

Answer 19

Microcalcifications

Question 20

Microcalcifications

Answer 20

Are punctuate echogenic foci without acoustic shadowing or associated comet-tail artifact

Question 21

What kind of vascularity do benign nodules have?

Answer 21

Peripheral flow patterns

Question 22

What kind of vascularity do malignant nodules have?

Answer 22

Internal vascularity

Question 23

Lymphadenopathy

Answer 23

Extension of a mass beyond the thyroid capsule into adjacent trachea or muscle is highly suggestive of an aggressive malignancy

Question 24

What are some suspicious features of local lymphadenopathy? (5)

Answer 24

1. Rounded shape
2. Loss of fatty hilum
3. Cystic change
4. Microcalcifications
5. Irregular internal hypervascularity

Question 25

What are the 2 most reliable benign features for the thyroid gland?

Answer 25

1. Near-complete cystic appearance

2. Ring-down artifact in colloid cysts/nodules