It is an invaluable diagnostic tool used to review thyroid nodules.

  • It is easy to perform and allows for an easy accession.
  • It is an inexpensive test.
  • It is radiation-free.
  • Its guidance in biopsies: Performing an ultrasound-guided biopsy enhances the diagnostic accuracy in cases of thyroid nodules.
  • It enables to ascertain the number and location of nodules.
  • It provides clear information about the structures of nodules. Some nodules are solid, while some are fluid-filled, i.e. cystic, and some others are mixed solid-cystic nodules.
  • Evaluation of blood flow using Doppler. Nodules are evaluated for cancer, based on the blood flow.

Suspected cancerous  nodules in ultrasonography

Microcalcification: A finding of a small microcalcification cluster indicates 80% chance of cancer, and requires a biopsy procedure to be performed on the nodule.


Irregular edge: A benign  nodule  has regular borders. The presence of serrated borders or deformed borders is highly suggestive of cancer.


Invasion of surrounding tissues: Once cancer develops in the nodule, it tends to spread into the thyroid tissue. When a cancerous nodule grows, it can also spread to other neighboring tissues besides the thyroid gland. These findings indicate that the nodule is cancerous with a probability of almost 100%.


Swollen lymph nodes: There are 600 lymph nodes in the neck. The lymph nodes can grow in cases of infections, and dental diseases. Ultrasonography shows whether the growing lymph nodes are benign or malignant. If the thyroid nodule is accompanied by a suspicious lymph node, the nodule is highly suggestive of cancer.


Hypoechogenicity: In ultrasonography, if anodule has a lower echogenicity (i.e. reflects less ultrasound waves) compared to a normal thyroid tissue, it is called "hypoechogenic". However, many benign nodules are hypoechogenic as well. It has not a high diagnostic value regarding cancer suspicion.


Thick, irregular halo or absence of halo: The nodule is surrounded by a band that looks like a picture frame. Any change on that band suggests the presence of a cancer.


Nodule's shape: The benign nodule is oval shaped. The malignant nodule is more rounded


Measurement of blood flow by Doppler:  The malignant nodule has an increased blood flow.

 

     

Microcalcification in the nodule.

       

The nodule has an excessive blood flow                 The nodule has irregular boundaries