Thyroid ultrasound

A thyroid ultrasound requires no complicated preparation, allowing the examination to be performed without loss of information, even in emergency situations. There's no need to fast or restrict fluid intake, as with other examinations. Simply wear comfortable clothing with an open neck, remove jewelry, and remove anything that could interfere with the transducer.

If you're taking medications that affect your hormonal levels or vascular health, inform your doctor.

A thyroid ultrasound can be performed on an outpatient basis. The procedure takes 10-30 minutes, depending on the complexity and the need to evaluate adjacent tissues and lymph nodes in the neck.

The patient lies supine with the neck slightly tilted back. The doctor applies a gel to the skin in the neck area to ensure good contact between the transducer and the skin.

The specialist then moves the transducer over the skin, scanning the thyroid gland in both longitudinal and transverse planes. If necessary, the doctor examines blood flow within the organ (Doppler mode) and evaluates the lymph nodes, adjacent tissues, and vessels.

To better visualize certain areas during the examination, the doctor may ask the patient to turn their head or hold their breath. It is important for the patient to remain calm—relaxed neck muscles allow for a clearer image.

After the procedure, the patient receives a photographic report and a medical report.

The following information is included in the thyroid ultrasound report:

• Lobe and isthmus parameters, gland volume and symmetry
• Shape and contours, presence of smooth or irregular borders
• Tissue echogenicity
• Structure: presence of nodules, cysts, calcifications, fibrous areas
• Blood flow characteristics in Doppler mode: velocity, direction, presence of increased vascularity
• Cervical lymph node status: size, shape, echostructure

The ultrasound report itself is not a definitive diagnosis – it is interpreted by an endocrinologist, taking into account laboratory data, the patient's symptoms, and the clinical context. If nodules or suspicious areas are detected, a fine-needle aspiration biopsy (FNAB) under ultrasound guidance is additionally prescribed.

Thyroid ultrasound plays an important role in the diagnosis of the following conditions:

• Nodular goiter: the formation of a dense area (nodule) in the thyroid tissue, benign or malignant. It usually causes no symptoms but requires monitoring.
• Diffuse toxic goiter: a uniform enlargement of the thyroid gland with increased hormone production. May be accompanied by weight loss, irritability, and palpitations.
• Thyroiditis: an inflammation of the thyroid tissue, which can be acute, subacute, or chronic. Often leads to neck pain, difficulty swallowing, and fluctuations in hormone levels.
• Hypothyroidism: a condition in which the thyroid gland does not produce enough hormones. An ultrasound may reveal a reduced size of the gland and signs of fibrosis.
• Thyroid cyst: a fluid-filled cyst. Usually benign, but requires monitoring.
• Adenoma: a benign growth with smooth edges that can cause hormonal imbalances.
• Thyroid cancer: a malignant growth that requires accurate diagnosis and treatment. Ultrasound reveals a dense nodule with irregular edges and increased vascularity.
• Hyperplasia: a general increase in the volume of the gland without nodules. Often observed with iodine deficiency and early stages of other diseases.
• Autoimmune diseases (e.g., Hashimoto's disease) are a condition in which the immune system destroys glandular cells. Ultrasound reveals a heterogeneous structure and a decrease in organ volume.