RadteraUltrasound Thyroid and Neck
USNo contrastHead & Neck
Indications
- Palpable neck mass or thyroid nodule
- Abnormal thyroid function / goiter
- Follow-up of known nodule
- Incidental nodule on cross-sectional imaging
- Cervical lymphadenopathy
Patient prep
- None
- Supine with neck extended; pillow under shoulders
Contrast
None / non-contrast
Technique
- High-frequency linear transducer 7-15 MHz
- Supine, hyperextended neck; survey both lobes and isthmus in long and transverse
- Color Doppler for nodule vascularity and parenchymal flow
- Survey central and lateral cervical nodal chains
Series / Sequences
| # | Series / Sequence | Plane | Notes |
|---|---|---|---|
| 1 | Right thyroid lobe | Long axis and transverse | Measure 3 dimensions (length, AP, width) |
| 2 | Left thyroid lobe | Long axis and transverse | Measure 3 dimensions |
| 3 | Isthmus | Transverse | Measure AP thickness |
| 4 | Any nodule | Two planes | Measure 3 dimensions; document composition, echogenicity, shape, margin, echogenic foci (TI-RADS) |
| 5 | Nodule Doppler | As needed | Vascularity |
| 6 | Cervical lymph nodes | As needed | Suspicious nodes (rounded, loss of hilum, microcalcs, cystic) |
Key points
- Characterize nodules using ACR TI-RADS (composition, echogenicity, shape, margin, echogenic foci) to determine FNA thresholds
- Taller-than-wide shape, irregular/lobulated margins, microcalcifications, and marked hypoechogenicity are suspicious features
- Report nodule size in 3 dimensions; document largest/dominant and clinically relevant nodules
- Evaluate cervical nodes for metastatic features
References
• AIUM Practice Parameter for the Performance of a Thyroid and Parathyroid Ultrasound Examination
• Tessler FN, et al. ACR Thyroid Imaging, Reporting and Data System (TI-RADS): White Paper of the ACR TI-RADS Committee. J Am Coll Radiol. 2017;14(5):587-595. link
• Radiopaedia: Assessment of thyroid lesions (ultrasound) link
• Tessler FN, et al. ACR Thyroid Imaging, Reporting and Data System (TI-RADS): White Paper of the ACR TI-RADS Committee. J Am Coll Radiol. 2017;14(5):587-595. link
• Radiopaedia: Assessment of thyroid lesions (ultrasound) link
Source: Researched — verify against your institution
Reference template — verify and adapt to your scanner, vendor and institution before clinical use. Not a substitute for clinical judgment.