Thyroid Disease & Thyroid Ultrasound

Thyroid disease in a community setting seems to be very common and is often discovered as an "incidental finding" with ultrasound of the carotid arteries.


Thyroid Ultrasound


The experience of the Technical Director of Vital Health Scores is that between 50 and 70% of every patient/client that I conduct ultrasound of the carotid arteries will be found to have abnormally large or structurally deranged thyroid glands.  These abnormalities mainly include benign fluid filling spaces called simple cysts, tissue filled or deranged targets called "nodules", and more complex and larger structures generally referred to as "masses".  The great majority of thyroid lesions found incidentally are benign, probably on the order of greater than 97%.  The remaining 3 % could be malignant lesions, possibly thyroid cancer.


The American Institute of Ultrasound in Medicine suggests that a state of the art thyroid ultrasound include the following:


  1. The location, size, and number of lesions.
  2. The nature of the blood flow and vascularity.
  3. How ultrasonically 'bright' the gland is and if the borders are regular or not.
  4. And noting the size and location of any abnormal appearing lymph nodes.

The parathyroid gland(s) are quite small and not routinely visible and analysed on a complete diagnostic thyroid ultrasound.

If, during a carotid artery screening ultrasound, the thyroid gland appears abnormal, it will be shown and mentioned to the client.  A decision can be made to make note of this finding on the carotid ultrasound screening report, or to proceed directly to a complete diagnostic ultrasound of the thyroid.  If the client has a family physician or internist, it may be appropriate for the patient/client to share this information with their physician with the purpose of seeking an opinion on whether or not an ultrasound is appropriate.

It does not always follow that a structurally abnormal thyroid will manifest in abnormal thyroid hormone levels in a blood test.  In like manner, abnormal thyroid function tests or signs and symptoms of possible thyroid dysfuction does not always manifest as a structurally abnormal thyroid in the form of a goiter, cysts, masses, nodules, or increased blood flow on ultrasonic Doppler (hypervascularity).

 

Author
Mark Zemanek Technical Director, Vital Health Scores

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