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Thyroid > Thyroid anatomy, scan technique, and pathology > Flashcards

Thyroid anatomy, scan technique, and pathology Flashcards

1
Q

What is the normal volume of a thyroid in males and females?

A

Males - 12-18cc
Females - 10-15cc

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2
Q

What part of a lesion and what piece of anatomy are you using to define the echogenicity of a nodule?

A

The solid portion compared to the thyroid parenchyma (hyperechoic) or the strap muscles (hypoechoic)

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3
Q

What hormones does the thyroid produce?

A

T3, T4, and calcitonin

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4
Q

What is produced as a precursor for the production of T3 and T4?

A

Thyroglobin

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5
Q

Where does the oesophagus sit in relation to the thyroid?

A

Posterior to left lobe

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6
Q

What are some US signs of glandular enlargement, aside from measurements?

A

Bulging of the anterior surface of both lobes and lateral extension of lobes over the CCA’s

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7
Q

What are three congenital abnormalities of the thyroid (+ brief description)?

A

Pyramidal lobe (persistant distal portion of the thyroglossal duct arising from isthmus)
Tubercle of Zuckerkandl (extension of normal thyroid tissue from posterior aspect of rt/lt lobe inferomedially)
Ectopic thyroid (check base of tongue for potential thyroid remnant - lingual thyroid)

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8
Q

What is a thyroglossal duct cyst?

A

Cyst which arises from a failure of the thyroglossal duct to shrink.

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9
Q

Where are thyroglossal duct cysts usually located?

A

Infrahyoid

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10
Q

What is thyroid hyperplasia and why does it occur?

A

Enlargement of the thyroid from anything that lowers intrathyroidal iodine levels.

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11
Q

What are colloid nodules?

A

Benign hyperplastic nodules made of thyroid tissue.

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12
Q

What are the US appearances of colloid nodules?

A

Isoechoic
Can be hyperechoic due to interfaces between cells and colloid

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13
Q

What are some benign features of thyroid nodules?

A

Hypoechoic halo - usually from peripheral vessel or oedema
Anechoic (cystic) areas from degenerative change
Bright echogenic foci with comet-tail artifact
Thin intracystic septations

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14
Q

What are the US appearances of multi-nodular goitre?

A

Multiple discrete nodules separated by normal tissue
Enlarged gland throughout
No normal tissue

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15
Q

What are the US appearances of benign follicular adenoma?

A

Difficult to distinguish from hyperplastic nodules
Often have hypoechoic halo from fibrous capsule and vessels
Spoke-wheel vessel arrangement

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16
Q

What are the US appearances of an intraparathyroid adenoma?

A

Round/oval well-circumscribed, hypoechoic, solid lesion
Hypervascular with marginal vessels

17
Q

What are the US appearances of ectopic thymus?

A

Well-defined, irregular lesion in/immediately caudal to thyroid
Dot-dash pattern

18
Q

What are the US appearances of papillary thyroid cancer?

A

Punctate echogenic foci (infarction of papillae tips)
Microcalcs
Hypoechoic solid tumour

19
Q

What are the US features of anaplastic thyroid cancer?

A

Large, ill-defined mass
Heterogenous echogenicity
Calcs
Invasion into soft tissues

20
Q

What does primary thyroid lymphoma look similar to?

A

Hashimotos thyroiditis

21
Q

What are the most sinister features of a thyroid nodule?

A

Solid
Hypoechoic
Taller than wide
Lobulated, irregular, or extrathyroidal extension
Peripheral rim calcs or PEF

22
Q

What is Grave’s disease?

A

Hyperfunction of the thyroid

23
Q

What are the US appearances of Grave’s disease?

A

Enlarged thyroid (may be more heterogenous than with diffuse goitre)
Hypoechoic
Hypervascularity

24
Q

What are the different types of thyroiditis?

A

Autoimmune (Hashimoto’s)
Acute (bacterial infection - rare)
Chronic (fibrosing form)
Post-partum

25
Q

What are the US appearances of Hashimoto’s thyroiditis?

A

Micronodulation (nodules 1-6mm in size) - flow normal or decreased within nodules
Diffuse, coarsened echotexture
Hypoechoic (generally)
Enlarged initially
Cervical lymphadenopathy near lower pole of gland

26
Q

What are the lab values of Hashimoto’s thyroiditis?

A

Hypothyroidism (low T3 and T4, high TSH)

27
Q

What are the lab values of Grave’s disease?

A

Hyperthyroidism (high T3 and T4, low TSH)

28
Q

What is sialadentis?

A

Enlarged
Hypoechoic
Hyperaemic

29
Q

What are some techniques that can be used to assess the composition of a thyroid nodule?

A

Use CD (mass/cyst)
Internal echoes may make the cyst look solid (ballot cyst or turn patient to get echoes to move)

30
Q

What are the US appearances of concerning PEF?

A

Discrete, <1mm, no acoustic shadows
Peripheral calcs

31
Q

What things could mimic PEF?

A

Back walls of tiny cysts

32
Q

What are normal LN appearances?

A

Ovoid in shape
Smooth margin
Echogenic hilum with CD
Uniform hypoechoic parenchyma

33
Q

What are some abnormal LN appearances?

A

Cystic change in the anechoic component
Peripheral or diffusely increased flow
>10mm AP diameter
Irregular blurred contours
Dislocation or indistinct hilum

34
Q
A

Thyroid (1 decks)

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