Ultrasound of the thyroid gland

Where to make ultrasound of the thyroid gland and why it is necessary to regularly undergo preventive examinations of this body? The thyroid gland is a part of the endocrine system, the disease or disruption of its functioning negatively affects the work of the whole organism. Ultrasound diagnosis allows to identify in time the foci of pathologies and to conduct treatment.

Indications for the USU of the thyroid gland

• Work in unhealthy conditions, stressful situations and frequent change of climatic zones.
• The patient's age is more than 40 years, diabetes and other endocrine system diseases.
• The use of hormonal drugs and a hereditary predisposition to the pathologies of the thyroid gland.

Methods of ultrasound of the thyroid gland

Vascularization of the thyroid gland can be assessed with color flow and pulse dopplerography. Depending on the clinical task (diffuse or focal thyroid disease), the aim of the study may be to quantify the vascularization of the thyroid gland or to determine its vascular structure.

Pulse dopplerography is used to measure the peak systolic velocity and volume of blood flow in the arteries of the thyroid gland. The lower thyroid artery drains from behind with the common carotid artery. The top of the fusion on the longitudinal scanner looks like the cross section of the vessel with the common carotid artery. Then the sensor rotates to visualize the ascending section of the lower thyroid artery, and the Doppler probe volume is located inside this segment. The upper thyroid artery, located medial to the common carotid artery in the upper pole of the thyroid gland, is visualized on a slightly altered longitudinal scanner. It is easy to detect in the opposite direction of the blood flow relative to the common carotid artery. The peak systolic velocity (PSS) in the vessels of the thyroid gland is normally 25 cm / s, and the volume of blood flow is 6 ml / min per vessel.

Diffuse thyroid disease can be identified by placing a color area above the area under investigation. This allows a semi-quantitative assessment of the blood flow of the parenchyma. Standard settings allow you to compare the consistency between different people and the same patient. This can not be achieved when tested on different machines or with different settings. Each ultrasound specialist must have experience working on a certain device before evaluating the degree of increase in blood flow.

Diffuse hypervascularization in the acute stage of Graves' disease is well expressed and can be considered pathognomonic for this disease. The mean peak systolic velocities are more than 100 cm / s, the volume of blood flow is more than 150 ml / min. Increased blood flow in the gland is maintained, even when with the help of drug therapy an euthyroid state is reached, and disappears only with time.

Hashimoto's thyroiditis has a similar pattern in B-mode. Color mode with sensitive settings shows increased blood flow, but it is less pronounced than with Graves' disease in the acute stage.

With thyroiditis, de Kervain inflammation does not affect the entire thyroid gland, but infiltration occurs with the appearance of a heterogeneous pattern. With ultrasound, a disordered pattern is identified with the presence of hyperechoic and hypoechoic regions.

Nodular hyperplasia is characterized by the presence of hyperechoic and isoechoic nodes. Often, a hypoechoic rim (halo) is defined, but unlike focal thyroid formations, it does not indicate malignancy of the process. The halo does not always correspond to the annular hypervascular pattern. In some cases, such a picture arises even in the absence of a halo in the B mode. Although there is annular hypervascularization with most adenomas, this symptom is non-specific, as it can be observed in both nodal hyperplasia and cancer.

Most thyroid cancers are hypoechoic with the presence of peripheral and central hypervascularization. In order to judge the suspicion of malignant formation, ultrasound signs of malignancy should be interpreted in conjunction with radionuclide research data (the "cold focus") and the clinical picture.

Critical Assessment

The standard method of examining patients with suspected head and neck tumors is CT, which allows you to simultaneously detect a tumor and assess the condition of regional lymph nodes. However, in CT, the only criteria that allow differential diagnosis between benign and malignant processes are the size of the node and the possible enhancement in the form of a rim after the introduction of contrast medium. If the dimensions of the node are within a doubtful value, CT should be supplemented with an ultrasound study that allows obtaining more criteria for comparative analysis.

Ultrasound with malignant lymphoma is effective for staging. The disadvantage is that the results, unlike CT, are not so easy to document. In addition, the ultrasound method can not assess the state of lymphoid tissue in the Valdeyra ring, which can swell with systemic diseases of the lymphatic system and cause a potentially dangerous narrowing of the pharynx.

Color duplex sonography does not provide accurate information about the functional state of thyroid nodules and for a differential diagnosis between benign and malignant processes. In this respect, color duplex sonography does not complement a fine needle puncture biopsy or radionuclide study. In diffuse thyroid diseases, especially with Graves' disease, color duplex sonography can help assess inflammatory activity and, in combination with laboratory data, is suitable for diagnosis and control.

Ultrasound scanning of the thyroid gland is performed during pregnancy, with unreasonable fluctuations in weight, irritability and negative symptoms from the cardiovascular system. During the study, the doctor determines the shape and location of the organ, the size and volume of lobes, the structure, the presence of neoplasms and blood supply. The conclusion of an ultrasound is not a diagnosis, but only information for an endocrinologist. As a rule, this procedure is accompanied by a study of blood to the level of hormones and examination of the entire body.

Kiev:

• Medical Center "MedErbis" - st. R.Okipnoy, 10B, tel. [phone].
• Diagnostic Center "Meddiagnostika" - Builders Lane, 4, ph. [phone].
• Clinic "My Family" - st. Voloshskaya, 50/38, tel. [phone].
• Oxford Medical Clinic - ul. Glubochitskaya, 40Х, tel. [phone].
• The network of medical clinics "Viva" - ul. Lavrukhina, 6, tel. [phone].

Moscow:

• Multidisciplinary medical center "120 for 80" - st. People's House, 14, tel. [phone].
• Medical Center "SM-Clinic" - st. Clara Zetkin, 33/28, tel. [phone]
• Clinic Best Clinic - ul. Lower Krasnoselkaya, 15/17, tel. [phone].
• Medical Center "Stolitsa" - Leninsky Prospekt, 90, tel. [phone].
• The network of diagnostic and treatment centers "Family Doctor" - Borislavsky proezd, 19A, tel. [phone].

St. Petersburg:

• Medical Center "Health" - Koroleva Avenue 48/5, tel. [phone].
• Medical Center "Liana" - Moscow Avenue, 36, tel. [phone].
• Center for Ultrasound Diagnostics - Udarnikov Avenue, 21, tel. [phone].
• "Proficlinic" - Engels Avenue, 50, tel. [phone].
• Medical Center "Our Clinic" - st. New Devyatkino, 101, tel. [phone].

[1], [2], [3], [4], [5], [6], [7], [8], [9]