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DRG3007 Sono > Week 3 > Flashcards

Week 3 Flashcards

1
Q

equipment used for small part sonography

A

high frequency linear probe
- wide near field
- excellent resolution
- excellent color Doppler

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2
Q

thyroiditis / hashimoto’s appear as

A

swiss cheese appearance

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3
Q

MNG

A

multi-nodular goiter

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4
Q

thyroid shape

A

butterfly

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5
Q

thyroid spans ___ vertebrae

A

C5-T1

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6
Q

thyroid location

A
  • around cricoid cartilage & superior tracheal rings
  • inferior to thyroid cartilage of larynx
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7
Q

thyroid blood supply

A
  • superior & inferior thyroid arteries
  • superior & middle thyroid veins
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8
Q

thyroid nerve supply

A

recurrent laryngeal nerve

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9
Q

thyroid function

A

produces T3 & T4 to regulate body temperature, growth & metabolism

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10
Q

what resolution probe for US thyroid

A

high resolution linear probe: 5 - 18 MHz

Curve linear probe with small footprint: 5 - 9 MHz for enlarged thyroid lobes

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11
Q

patient position for US thyroid

A

patient supine with head slightly hyperextended and turn head to contralateral side

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12
Q

US thyroid scanning protocol

A

CALI VDF

  • isthmus measurement
  • color doppler of both lobes
  • longitudinal scans through each lobe
  • axial scans of whole gland
  • focal lesions
  • vascular flow
  • document abnormalities
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13
Q

longitudinal scan starts from

A

right lobe

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14
Q

what does longitudinal scan & measure

A

scans medial, mid, lateral plane & measures length

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15
Q

what does axial scan & measure

A

scans upper pole, interpolar, lower pole, and measures width & AP diameter

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16
Q

how does normal thyroid (transverse) appear as

A

WESH

  • echogenic thyroid capsules
  • well circumscribed
  • smooth & homogenous echotexture
  • hyperechoic to adjacent muscles
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17
Q

difference between pyramidal & normal thyroid lobe

A

pyramidal has persistent remnant of thyroglossal duct whereas normal does not

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18
Q

reporting of thyroid gland includes

A

position, shape, size, content, echogenicity, vascular pattern

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19
Q

reporting of thyroid nodule

A

size, location, margin, composition

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20
Q

US thyroid scans can evaluate the following:

A
  • thyroid parenchyma & gland size
  • nodule size, location & sono characteristic
  • presence of sus cervical lymph nodes
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21
Q

ACR TI-RADS assess for

A

composition, echogenicity, shape, margin, echogenic foci

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22
Q

how does MNG appear as

A

enlarged thyroid gland

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23
Q

common causes of MNG is

A

insufficient thyroid hormone & tracheal and esophageal compression

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24
Q

sono features of MNG

A
  • enlarged & heterogenous thyroid
  • focal / diffused replacement of thyroid parenchyma
  • nodules may contain cystic degeneration
  • calcifications
  • hemorrhage
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25
Q

thyroiditis

A

inflammation of thyroid gland that causes temporary / permanent of thyroid function

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26
Q

thyroiditis impairments include:

A

hyperthyroidism & hypothyroidism

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27
Q

causes of thyroiditis

A

infection, autoimmune, meds, ionizing radiation

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28
Q

different forms of thyroiditis distinguished using

A

clinical findings, lab results, US

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29
Q

grave’s disease

A

autoimmune disease commonly in women with generalized thyroid enlargement & thyrotoxicosis

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30
Q

most common cause of Grave’s disease

A

hyperthyroidism

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31
Q

sonography features of Grave’s disease

A
  • enlarged thyroid
  • hypoechoic & coarse texture
  • thyroid inferno
  • gland size proportional to vascular activity
  • increased velocities in inferior thyroid artery
  • lobulated gland surfaces
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32
Q

most common type of thyroiditis

A

hashimoto’s thyroiditis

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33
Q

hashimoto’s thyroiditis leads to increased risk of __

A

non-Hodgkin’s lymphoma

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34
Q

acute hashimoto’s thyroiditis appear as

A
  • focal with small, hypoechoic, avascular nodules with ill defined outlines
  • diffused with multiple nodules of reduced echogenecity & vascularity separated by echoic, thickened fibrous septae, lobulated margins & generalized enlargement
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35
Q

chronic hashimoto’s thyroiditis appear as

A
  • densely echogenic, small glands
  • discrete thyroid nodules develop & associated with cervical lymphadenopathy
36
Q

hyperplastic / colloid nodules

A

overgrowth / involution of normal follicular tissue; commonly seen in MNG

37
Q

what is common with hyperplastic / colloid nodules

A

hemorrhage & necrosis

38
Q

sono features of hyperplastic / colloid nodules

A
  • well defined, smooth wall
  • mixed echo texture, low level
  • hypoechoic peripheral rim with egg-shell calcifications
  • comet tail artifacts
39
Q

sono features of adenoma / follciular adenoma

A

solid mass with smooth peripheral halo, increased flow if hyperfunctioning

40
Q

sono features of papillary carcinoma

A
  • predominantly hypoechoic
  • incomplete peripheral halo
  • septa with vascularity
41
Q

FNA / Fine Needle Aspiration

A

minimally invasive, US is best to obtain adequate info for accurate cytologic evaluation

42
Q

parathyroid function

A

makes PTH in response to low Ca2+ levels

43
Q

normal parathyroid sono features

A
  • usually not seen & homogeneously hypoechoic
  • echogenic thyroid capsule separates thyroid from parathyroid gland
44
Q

cervical lymph node on gray scale

A
  • oval shape
  • echogenic helium
  • hypoechoic compared with adjacent muscles
45
Q

cervical lymph node on color & power doppler

A
  • hilar vascularity / appears avascular reactive nodes predominantly show hilar vascularity
46
Q

breast are anchored to __ by __

A

pec muscles; suspensory / Cooper’s ligaments

47
Q

breast zones

A

premammary, mammary, retromammary zones

48
Q

where do most breast pathology arise from

A

mammary zone

49
Q

what does mammary zone contain

A

lobar ducts, branches, most of TDLU, most of fibrous stromal tissue

50
Q

blood supply of breasts

A

axillary, internal thoracic, anterior intercostal arteries

51
Q

lymphatic drainage of lateral quadrant breasts

A

anterior axillary & pectoral nodes

52
Q

lymphatic drainage of medial quadrant breasts

A

internal thoracic nodes

53
Q

lymphatic drainage of posterior portions of breasts

A

posterior intercostal nodes

54
Q

nipple sono feature

A

hypoechoic as intense acoustic shadow with presence of retroareaolar ducts & blood vessels

55
Q

what lymph nodes seen at axillary tail

A

hypoechoic cortex & hyperechoic fat hilum

56
Q

breast US in young patients

A

very little fat in subcutaneous / glandular layer as homogeneously dense or hyperechoic

57
Q

breast US in middle aged patients

A

dense glandular tissue with some fatty displacement as hyperechoic areas with some hypoechoic area between

58
Q

breast US in older patients

A

mainly hypoechoic

59
Q

breast US in pregnant & lactating patients

A

enlarged breasts & dilated milk ducts appear as cystic spaces within breasts

60
Q

breast US patient positioning

A

patient supine with arm of examined side above hear & resting on pillow

small pillow placed under patient’s shoulder on side being examined & allow breast to be flattened over chest wall

61
Q

breast US equipment

A

high resolution linear probe: 7 - 17 MHz
curvilinear probe: 2 - 9 MHz

62
Q

Breast US concerned lesions should be imaged in 2 planes with 3D measurement & described by:

A

clockface position, distance from nipple + skin surface + pectoralis muscle

63
Q

Breast US scanning movements include

A

radial, anti-radial, longitudinal, transverse

64
Q

US breast simple cyst sono features

A

anechoic, imperceptible back wall, enhanced transmission of sound, oval or round shape with circumscribed margins

65
Q

US breast complex cyst sono features

A

internal echoes within cyst, avascular, posterior acoustic enhancement, debris mobile / stationary

66
Q

US breast complex mass sono features

A

heterogenous echotexture, complex echogenicity, posterior acoustic enhancement, avascular

67
Q

fibroadenoma US sono features

A

well circumscribed, homogeneous echogenicity from isoechoic to hypoechoic, thin, pseudo echogenic capsule

68
Q

types of breast cancer

A
  • ductal
  • mucinous
  • lobular
  • mixed tumor
  • inflammatory
69
Q

US breast ductal carcinoma in situ

A

microcalcifications, echogenic material within duct, internal vascularity

70
Q

US breast invasive ductal carcinoma

A
  • spiculated / microlobulated margins
  • posterior shadowing
  • markedly hypoechoic / heterogenous
  • micro-calcifications
  • thick echogenic halo
71
Q

US breast invasive carcinoma

A
  • taller than wide
  • subtle hypoechoic mass with irregular margins
  • internal vascularity
  • posterior shadowing
72
Q

lesion description

A
  • echogenicity
  • margins
  • artifacts
  • dimensions
  • shape
  • compressibility
  • presence of lobulations
  • capsular thickening
  • vascularity
73
Q

intracapsular breast implant sono features

A

stepladder sign
- when implant shell ruptures but fibrous capsule formed by breast remains intact

74
Q

extracapsular breast implant sono features

A

snowstorm
- change in implant contour & implies intracapsular rupture

75
Q

how does hashimoto’s thyroiditis appear as

A

swiss cheese apperance

76
Q

how does grave’s disease appear as

A

marked increase vascularity = thyroid inferno

77
Q

how does thyroid nodule appear as

A

multiple thyroid nodules

78
Q

how does goiter appear as

A

enlarged homogenous gland

79
Q

how does MNG appear as

A

enlarged heterogenous gland with ill defined nodules

80
Q

TIRADS

A

thyroid image reporting and data system

81
Q

thyroid gland reporting consists of

A

position, shape, size, content, echogenicity, vascularity

82
Q

thyroid nodules reporting consists of

A

size, location, margins, composition

83
Q

reporting guidelines used are ___

A

ATA, TIRADS, BTA

84
Q

difference between ATA & TIRADS

A

ATA focuses on vascularity whereas TIRADS does not

85
Q

taller than wide or wide than taller is dangerous

A

taller than wide

DRG3007 Sono (11 decks)

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