Thyroid

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Ultrasound images of diseases of thyroid gland:

 

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1) Agenesis of the thyroid:

ultrasound image of agenesis of the thyroid      color doppler image shows absent left lobe of thyroid

both lobes of the thyroid are absent      sonography of the thyroid shows agenesis

Sonography of the thyroid in this 1 yr. old female child revealed congenital absence of the entire thyroid. Note the empty fossae where the right and left lobes would normally lie. The carotid artery and jugular vein of both sides are seen in the color doppler images. These ultrasound and color doppler images suggest congenital agenesis of the thyroid.

Reference: http://content.nejm.org/cgi/content/abstract/321/1/13 (free abstract).

2) Hemiagenesis of the thyroid:

ultrasound image shows absent right lobe of thyroid     ultrasound image showing hemiagenesisof right lobe

color doppler image of hemiagenesis of thyroid

This 18 yr. old female patient presented with symptoms of hypothyroidism. On sonography of the thyroid, we observed: 1) absence of the right lobe of thyroid 2) normal or slightly enlarged left lobe and isthmus of thyroid c) mild to moderate augmentation of vascularity of the left lobe on color doppler imaging. These ultrasound images favor a diagnosis of congenital absence of the right lobe or hemiagenesis of the right lobe with Hashimoto's thyroiditis. This condition is found typically in females with left lobe usually absent.

Reference: 1) http://medind.nic.in/iaw/t05/i2/iawt05i2p53.pdf (free article and images) 

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3) Hashimoto's thyroiditis:

ultrasound images of thyroiditis     Ultrasound images of Hashimoto's thyroiditis

Ultrasound image of Hashimoto's thyroiditis    sonography of hashimoto's thyroiditis

Sonography of the thyroid gland in this middle aged female patient reveal:

1) hypoechoic thyroid gland 2) coarse echotexture of the gland 3) fine linear echoes within the thyroid parenchyma s/o fibrosis 4) Color doppler imaging reveals augmentation of the vascularity of the thyroid gland. These ultrasound images are diagnostic of Hashimoto's thyroiditis. Images taken using a Toshiba Nemio- XG color doppler machine.

Reference: 1) Hashimoto's thyroiditis article (free article and images)

2) http://www.emedicine.com/med/TOPIC949.HTM (free article and images)

4) Hyperthyroidism:

hyperthyroidism sonography of     ultrasound image of thyrotoxicosis

color flow image in hyperthyroidism  

These ultrasound/ color doppler images (taken with a Nemio-XG color doppler scanner), reveal markedly increased vascualrity throughout the thyroid gland. Some degree of inhomogeneity is also present. The patient was a middle aged female with typical features of thyrotoxicosis. Ultrasound images are diagnostic of hyperthyroidism.

Reference: http://www.emedicine.com/Radio/topic315.htm (free article)

5) Multinodular goiter:

goiter   ultrasound image multinodular goiter

goiter ultrasound imaging   normal sized left lobe

The above ultrasound images show- 1) a huge complex mass (8 x 6 cms.) containing both cystic and solid areas, in the right lobe of the enlarged thyroid. 2) relatively spared left lobe which shows normal size, but has fine nodularity. These ultrasound images are highly suggestive of a multinodular goitre.

http://www.patient.co.uk/showdoc/27000670/ (free article)

6) Ultrasound and color doppler imaging of multinodular goiter:

multiple cysts in both lobes of thyroid     multinodular goiter

cystic lesions of the thyroid    cystic and solid lesions are seen in the thyroid

ultrasound and color doppler images of multinodular goiter

The above ultrasound and color doppler images reveal multiple cystic lesions in both lobes of the thyroid. There is also evidence of few nodular, solid masses within the lobes. Color doppler imaging reveals multiple vessels around the lesions. These images suggest multinodular goiter, more of a cystic variety.

7) Sublingual thyroid:

thyroid gland in sublingual region     ultrasound image of sublingual thyroid

sonography of sublingual thyroid    sublingual thyroid showing hemorrhagic cyst

 simple cyst of left lobe of thyroid    simple cyst of left lobe of thyroid

This young lady had a swelling in the right side of upper neck of acute onset. Ultrasound images of the neck reveal an extension of the right lobe of thyroid gland into the sublingual region of the neck. This showed a thick-walled cyst with thickened septae within it. The left lobe of thyroid also shows a simple colloid adenoma (cyst) within it. These ultrasound images suggest hemorrhagic cyst of sublingual thyroid. Images taken with an ATL ultrasound machine courtesy of Mr. Shlomo Gobi, Israel. 

Reference: 1) http://www.ajnr.org/cgi/reprint/16/5/1117.pdf (free article)

                 2) http://jcem.endojournals.org/cgi/content/full/88/11/5145  (free article and images)

                 3) http://pediatrics.aappublications.org/cgi/content/abstract/38/4/647 (abstract)

8) Ultrasound image of hemithyroidectomy:

sonography of hemithyroidectomy

This sonographic image shows a post-surgical absence of the right half of the thyroid gland. Hemithyrodiectomy is usually done in cases of suspected thyroid malignancy. Here the normal left half of the thyroid is seen in transverse section. Ultrasound image taken with a Toshiba Powervision color doppler/ ultrasound machine, courtesy of            Dr. Ravi Kadasne, MD, UAE.

Reference: Thyroidectomy article

9) Superficial neck masses- lipoma:

lipoma of the neck     sonography of neck lipoma

ultrasound image of neck lipoma     ultrasound image shows mass in the neck

normal thyroid gland is visualized     <<The normal thyroid is visualized above the mass, though small in size.

This teenaged female presented with a palpable and visible mass in the suprasternal region just below the thyroid. On sonography, the mass is homogenous in echotexture, measures 5.5 x 2.5 x 2.6 cms., relatively hyperechoic with echogenicity just less than the normal thyroid (which was well visualized). Color doppler imaging shows no vascularity in the mass. These ultrasound images suggest either an ectopic thymic mass or a subcutanous mass like lipoma. The mass was aspirated and proved to be a lipoma of the neck. Images taken using a Toshiba Nemio XG by         Joe Antony, MD, India.

Reference: http://www.ajnr.org/cgi/reprint/19/3/505 (an excellent free article and images).

10) Hemorrhagic colloid cyst of the thyroid:

hemorrhagic thyroid cyst      fine debris is present in the colloid cyst of thyroid

The above sonographic images of the right lobe of thyroid show a large cyst measuring 1.8 x 1.5 cms. The walls appear irregular with fine debris within the lumen of the thyroid cyst. Color doppler image (on right) shows normal vascularity with no vessels within the cyst. These ultrasound images suggest Hemorrhagic colloid cyst of the thyroid.

Reference: http://www.emedicine.com/Radio/topic695.htm

Follow up ultrasound images (same patient above) 2 months later:

reduction in size of colloid cyst     colloid cyst 2 months later

The colloid cyst, has almost completely resolved and measures 0.8 cms. in size. Such dramatic improvement and reduction is known to occur in colloid cyst of the thyroid, especially if hemorrhagic in nature.

11) Malignant thyroid nodule:

malignant thyroid nodule     hypoechoic thyroid nodule

This patient underwent sonography of the thyroid, revealing a markedly hypoechoic nodule of 1.1 cms. width, in the left half of the isthmus of the thyroid. The lesion also shows echogenic specks s/o microcalcification and an irregular border. Also note that the nodule is as tall as it is wide. All these ultrasound findings favor a diagnosis of malignancy on this thyroid nodule. Images courtesy of Dr. Ravi Kadasne, UAE.

Reference: http://www.ajronline.org/cgi/reprint/178/3/687.pdf (excellent article-- free)

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  This page was last edited on: Friday October 24, 2008 03:28 PM  

Copyright ©   2007- All rights reserved- www.ultrasound-images.com Dr. Joe Antony, MD,    265, Girinagar, Cochin- 20, India.

Contact: joe@ultrasound-images.com or drjoea (at) gmail.com