Добавил:
Опубликованный материал нарушает ваши авторские права? Сообщите нам.
Вуз: Предмет: Файл:
Atlas of Human Body Ultrasound Scanning_ Methods and Diagnostic Applications ( PDFDrive ).pdf
Скачиваний:
177
Добавлен:
29.07.2022
Размер:
40.13 Mб
Скачать

Thyroid Scanning

4

 

Li Tan and Jianchu Li

 

Abstract

In this chapter, thyroid scanning is introduced, including scanning method, measurement and normal value, and clinical applications. The patients are usually placed in the supine position with the mild hyperextension of neck. The probe is placed at the throat, scanning the both lobes in the transverse and longitudinal planes. In addition, the blood distribution in the thyroid parenchyma should be assessed on color Doppler. The peak systolic velocity of the superior and inferior thyroid artery is acquired on spectral Doppler.

L. Tan (*) • J. Li

Department of Ultrasound, Peking Union Medical College Hospital,

Dongcheng District, Dongdan North Street 53, Beijing, China

e-mail: tanlixg@163.com

© Springer Nature Singapore Pte Ltd. and People’s Military Medical Press 2018

33

M. Zhang (ed.), Atlas of Human Body Ultrasound Scanning, https://doi.org/10.1007/978-981-10-5834-9_4

34

L. Tan and J. Li

 

 

1\ The Maximum Transverse

Scanning of the Thyroid

Fig. 4.1  The maximum transverse scan of the thyroid 1 sternocleidomastoid, 2 jugular vein, 3 carotid artery, 4 left and right lobes, 5 isthmus, 6 sternohyoideus, 7 sternothyroid, 8 trachea, 9 esophagus, 10 left and right musculus longus colli

6

1

7

4

2

3

10

1.1\ Scanning Method

1.2\ Section Structure

5

4

8

9

10

Patients are usually scanned in the supine position with the neck slightly hyperextended. The probe is placed at the throat, scanning the both lobes in the transverse planes from the level of fifth cervical vertebra to the seventh.

The transverse view of the thyroid and the surrounding structures:(1) sternocleidomastoid, (2) jugular vein, (3) carotid artery, (4) left and right lobes, (5) isthmus, (6) sternohyoideus ,(7) sternothyroid, (8) trachea ,(9) esophagus, and (10) left

4  Thyroid Scanning

35

 

 

and right musculus longus colli. On sonography, the thyroid parenchyma is isoechoic and much brighter than sternocleidomastoid; the normal parathyroid gland posterior to the lateral lobes is usually invisible.

1.3\ Measuring Method and

Normal Value

On the maximum transverse section, the width of the lateral lobes is measured from the edge of the trachea to the most lateral border of the thyroid gland. The anterior-posterior distances are measured on the same view. The anterior-posterior distance of the thyroid isthmus is measured from the surface of the isthmus to the anterior wall of the trachea. In China, the current normal range is less than 2 cm for the anterior-posterior distance and the width of the lateral lobe. But in some

individuals, the width may be 2.1–2.5 cm. The normal range of the anterior-posterior distance is less than 0.5 cm for the isthmus.

1.4\ The Clinical Application

Value

This section is used to observe the size, shape, borderline, and internal architecture of the thyroid gland, to evaluate the number, size, borderline, internal and posterior echogenicity of the nodules, calcification or not, and the pattern of calcification. The echogenicity of the thyroid parenchyma is determined using the ipsilateral salivary gland as the reference. The echogenity of the nodule is evaluated in comparison with the adjacent gland tissue. An anterior-posterior distance of the lateral lobe more than 2 cm indicates thyroid enlargement.