Thyroid ultrasound is used in clinical practice to assess thyroid gland
volume and vascularity, assess thyroid nodules and cervical lymph nodes, examine the
parathyroid glands in patients with primary hyperparathyroidism, guide biopsies,
aspiration and ablation of thyroid and anterior neck structures, and in post-operative
thyroid cancer surveillance. However, thyroid ultrasound is not suitable as a screening
tool of the thyroid. Ultrasound examination of the thyroid follows a systematic
approach beginning with the thyroid gland volume, echogenicity, echotexture, Doppler
flow and a detailed examination of any thyroid nodules. This is followed by an
examination of the anterior neck cervical lymph nodes, and the parathyroid glands if
clinically indicated. The normal thyroid gland is echogenic compared to the neck
muscles and displays little or no vascularity on Doppler study. The size of a normal
thyroid gland is 4-6 cm in length, 1.3-1.8 cm anteroposteriorly, and the isthmus width
is less than 6 mm. The thyroid ultrasound report should provide information about the
examination technique, a brief summary of the indications for the ultrasound, detailed
findings of the examination, conclusions and management recommendations.
Keywords: Cervical lymph nodes, Doppler, Echogenicity, Echotexture,
Indications, Microbubble contrast, Margins, Nodule, Retrosternal goitre, Thyroid,
Thyroid ultrasound reporting, Thyroid volume, Transducer, Ultrasound,
Ultrasound elastography.
