Often, the way the thyroid gland does not attach much importance. At the same time, the treatment of many diseases can be directly related to deviations in the work of this small organ. Thanks to modern technology, it became possible to study its functioning using ultrasound.
Grounds for
In order to prescribe an ultrasound of the thyroid gland, there must be certain grounds or indications. After a patient’s interview by a doctor to establish an accurate diagnosis, it is one of the first to be assigned among other studies. Here is a sample list of indications for the appointment of ultrasound:
- Difficulty swallowing.
- Swelling in the neck.
- Bouts of suffocation.
- Drowsiness, apathy, fatigue.
- Jumps in body temperature for no apparent reason.
- Increased irritability.
- A sharp decrease or weight gain.
- Pregnancy planning and age over 40 years.
- Discontinuation of oral contraceptives, hormone-containing drugs.
- Failures in the heart rhythm, diabetes.
It is also worth paying attention to deviations from the norms of indicators of such hormones as TSH, T3 and T4. The presence of hereditary endocrine diseases deserves some attention. As well as living in a region with poor environmental conditions. Any neoplasms in the thyroid gland, even benign ones, can adversely affect the general well-being and work of vital organs.
Thyroid structure
The internal structure of the gland looks like an isthmus that connects two lobes. Visually, some compare its shape with the letter "H" or a butterfly. In some cases, in some patients, an ultrasound of the thyroid gland shows that there is an additional fraction in the form of a pyramid located on top of the isthmus or next to the organ itself.
In children during intrauterine development, the correct division of the thyroid glands may not occur. If it happened only partially, then ultrasound diagnoses aplasia of the lobe or complete aplasia, if the gland remains completely undeveloped.
According to the location of the organ, it is customary to distinguish low, pathological (aberrant) or typical. In practice, there are also areas of the gland with obvious developmental abnormalities.
Preparation before the study
If we talk about adult patients, it is worth noting that the procedure can be performed at any time. As for women, they may have a question: is there a need for special preparation for ultrasound of the thyroid gland and on which day of the menstrual cycle is it better to approach? The answer is: no matter what day on the calendar, the study is carried out without special requirements. Hormones do not have any effect on the structure and structure of the thyroid gland.
Before conducting a child’s research, parents must explain in advance what it will be and what it is done for. Of course, if a child, by virtue of age, can understand an adult. It’s better to tell in advance how thyroid ultrasound is done and, most importantly, it doesn’t hurt at all. An hour and a half before the study, the child must be fed so that the food has time to be absorbed by the body and there is no gag reflex during the exposure of the sensor to the area of ​​the thyroid gland.
Before the study, the doctor should tell about the essence of conducting and preparing for ultrasound of the thyroid gland. If the procedure is carried out in a local clinic, then you need to bring a diaper and a towel, water. In private medical centers all this is included in the price, as a rule, there is a cooler and there is no need to take all this with you.
How is an ultrasound in adults
Like most studies, ultrasound of the thyroid gland is done in a horizontal position. The patient needs to strip to the waist so that the doctor can have access to the neck, as the gel is applied and its contact with clothing should be avoided. For the convenience of diagnosis, the doctor can put a roller under the neck. The duration of the procedure depends on what will be determined on the screen. If there are no deviations, then the doctor will confine himself to measuring the general parameters (length, width, thickness of organ lobes).
Otherwise, the study of neoplasms, changes, determining their size, identifying the cause (if possible visualize) may require more time. If we talk about standard procedures, then they last about 10-15 minutes.
How is an ultrasound of the thyroid gland in children
Ultrasound of the thyroid gland in children does not differ from adults. It is worth noting that many people endure this study much more easily than other planned procedures. Despite the absence of certain requirements, before the study, children first of all need to create an atmosphere of trust in the doctor and calm. The adult must make sure that the child does not turn his head, does not get up and does not talk.
The procedure is carried out by a diagnostic doctor, in rare cases, by the attending physician himself. The study takes place in a prone position, the child needs to expose the neck. Further manipulations do not differ from adult ultrasound. It is allowed to take the child in his arms or put him on himself.
What do you pay attention to during an ultrasound?
The main area of ​​diagnosis is the study of the size of the thyroid gland. Ultrasound can determine compliance or deviation from the norm. In the second case, the specialist will need to establish the reasons, knowing about which the endocrinologist in the future will be able to choose the right treatment regimen.
The parameters that pay attention in the first place:
- The structure of the thyroid gland.
- Determination of the volume of its shares, as well as linear parameters.
- Blood supply, including the use of doppler, which allows you to determine the degree of blood saturation of certain areas of the thyroid gland.
- The presence of formations, tumors, cysts, abscesses, nodes.
- Enlarged lymph nodes.
- The presence of calcifications.
In private medical centers, at the end of an ultrasound of the thyroid gland, they take photos of problem areas that help the doctor visually examine them and prescribe the right treatment.
What is considered the norm during the diagnosis
When the diagnostician starts to touch the patient’s neck with a sensor, he should see a clear picture on any monitor in the monitor. When an ultrasound scan of the thyroid gland is done, the norm is defined as a homogeneous structure, without echogenic inclusions, blackouts, all areas have the same color.
Separately, it should be said about the volume of the body, which are taken into account depending on the gender and age of the patient:
- Children aged 6 to 10 years - 8 ml.
- Adolescents from 11 to 14 years old - 10 ml; from 15 to 18 years - 15 ml.
- Women over 19 years old - up to 18 ml.
- Men from 19 years old - up to 25 ml.
If an ultrasound study is performed in a child or adolescent, it is worth considering their age. Since changes occur in the thyroid gland during the period of intensive growth. In girls, it is usually less than in boys.
If we talk about the size standards for ultrasound of the thyroid gland, the decoding should contain the following values:
- Width - 1-1.8 cm.
- Length - 2.5-6 cm.
- Thickness - 1.5-2 cm.
In some people, an isthmus may be absent, if it is present, sizes ranging from 4 to 8 mm are considered normal, the parathyroid gland should be in the region of 2-8 mm.
Ideally, during an ultrasound of the thyroid gland, no neoplasms and oversize should be detected. Calcinates and nodes of no more than 1-3 cm are also considered within the permissible limits. If they exceed these values, then there is a risk of developing a malignant tumor. To clarify the diagnosis, a biopsy may be required to determine the nature of the tumor.
What are the deviations from the norm
If the doctor diagnoses an abnormality on ultrasound of the thyroid gland in the direction of increase, then this may indicate the development of such diseases as:
- Thyroiditis - is formed as a result of the inflammatory process, which in most cases does not change the structure of the thyroid gland, however, the gland can be increased due to the presence of inflammation. It is customary to distinguish between autoimmune, quiet and subacute thyroiditis.
- Hypothyroidism - occurs due to insufficient production of the necessary hormones by the body.
- Endemic goiter - formed due to iodine deficiency. It may not appear in any way, except for an enlarged thyroid gland. A nodular goiter can also be determined, which has clear contours and is diagnosed as a focus of increased density.
- Autoimmune pathologies - the presence of antibodies in the gland itself.
- Tumor, cancer, adenoma - if they are malignant, then the contours will be fuzzy, with germination in neighboring tissues. Benign are separated from healthy areas, have a dense structure. It is possible to finally determine the nature of the tumor only after taking a biopsy.
The lack of timely therapy for thyroiditis can lead to the development of a purulent process and further to hypothyroidism. If measures are taken in time, after its treatment there are nodes or focal masses with sizes less than 1 cm. Deviations from the norms, which show that there is a decrease in its size on ultrasound of the thyroid gland, can cause antitumor therapy as a result of damage to the pituitary or hypothalamus. Valid are considered if the thyroid gland is less than ÂĽ-â…“ from the norm. However, its functions do not suffer from this.
Fuzzy thyroid contours on ultrasound may indicate the presence of an inflammatory process. This diagnosis can be confirmed by an increase in blood flow in the tissues of the lymph nodes, the presence of microcalcifications.
Cysts and neoplasms
During the thyroid ultrasound procedure, cysts can be detected. They are visualized due to the fact that they are filled inside with a colloid or liquid, as a result of which the signal from the ultrasonic sensor cannot pass through them. A dense shell outlines the contours of the cyst and the diagnostician can determine its size and structure.
When the doctor generates the results, in decoding ultrasound of the thyroid gland may indicate the presence of hyperechoic area. In order to confirm the diagnosis during a re-examination or during the same procedure, the doctor additionally resorts to elastography. It allows you to diagnose the nature of benign and cancerous formations. Moreover, they are characterized by the following features: fuzzy contours, vertical sizes are larger than horizontal, vessels inside the node are visualized on the monitor. This most often suggests that the tumor is malignant. However, with benign neoplasms, they can also be detected.
When the cyst does not cause inconvenience or discomfort, choose an observational method of therapy. Otherwise, it can prevent swallowing, crush the tissue, and then a decision is already made to remove it.
Ultrasound during pregnancy
Women who are in position undergo a large number of studies. If even before the onset of pregnancy there were problems in the thyroid gland, the indication for ultrasound may be justified, since it allows you to prevent the deterioration of health in time. Timely diagnosis using this method is considered safe and has no contraindications even in such a period. However, even if previously there were no problems with the thyroid gland, then if a disturbing symptom is found, you should consult a doctor.
The reasons for the diagnosis can be all of the above reasons, as well as the presence of seals during palpation of the organ. Acceptable are considered an increase in size from the norm by more than 16%, which is explained by an increased load on the gland during pregnancy.
Timely diagnosis allows you to detect a decrease in hormones produced by organisms, which is fraught with a deterioration in the general well-being of the pregnant woman. In this connection, she may be present leaps in mood, causeless cough.
Research results
One of the important parameters in the results of ultrasound is echogenicity. It allows you to determine the density of the organ and the tumors present in it. By echogenicity it is customary to understand the ability of tissues to reflect ultrasonic waves of a sensor. There are four types:
- Hyperachogenic - full reflection of ultrasound waves, the studied areas have a light tone, characteristic of connective tissue in the thyroid gland.
- Hypoechoic - in which the sensor waves are weakly reflected, the presence of dark areas can talk about nodes with fluid or cysts. To clarify their structure, a Doppler is used. In the case when the neoplasm around has a dark spot, it is worth excluding a cancerous tumor.
- Isoechoic - a partial reflection of ultrasound waves; on the monitor, the isoechoic areas are tinted with gray. As a rule, this substance is gel-like in its composition contained in colloids.
- Anechoic - ultrasonic waves are completely absorbed, and on the monitor they turn black. Most likely, it can be blood vessels, nodes containing fluid, infiltrates. In most cases, such neoplasms are benign.
If the first two types are identified, the endocrinologist must conduct additional studies and analyzes in order to establish an accurate picture of the disease.
At the end of the diagnosis, the specialist reflects the data obtained in the ultrasound protocol of the thyroid gland. This conclusion cannot serve as a basis for making a final diagnosis. This is the prerogative of the attending endocrinologist. Since only he has on hand the results of all studies that contain data on the state of the hormonal system, the ability of the gland to accumulate iodine, and others.