Key Components of a Comprehensive Thyroid and Parathyroid Ultrasound Report

Thyroid gland/general

Thyroid nodule

Lymph nodes

Thyroid parenchyma (homogeneous or heterogeneous)

Number of nodules in each lobe

Purpose of lymph node evaluation

Size in three dimensions

Clinical significance of each nodule

Size in three dimensions

Size of the isthmus

Size in three dimensions

Location

Echogenicity

Location in the gland (both in the superior/inferior and in the anterior/posterior orientation)

Internal architecture

Vascularity

Whether the nodule is taller than wider

Presence of hilum

Calcification patterns not associated with nodules

Contour

Shape

Pyramidal lobe

Suspicion for extrathyroidal extension

Calcifications

Mediastinal extension

Internal architecture

Vascularity

Tracheal deviation

Echogenicity

Suspicion of invasion of nearby structures/extranodal extension

Thyroglossal duct cyst

Non-suspicious echogenic foci

Overall impression (suspicion of metastasis)

Calcifications

Vascularity

Table 2.2

ATA recommendations [4]

Thyroid gland/general	Thyroid nodule	Lymph nodes
Thyroid parenchyma (homogeneous or heterogeneous)	Number of nodules in each lobe	Purpose of lymph node evaluation
Size in three dimensions	Clinical significance of each nodule	Size in three dimensions
Size of the isthmus	Size in three dimensions	Location
Echogenicity	Location in the gland (both in the superior/inferior and in the anterior/posterior orientation)	Internal architecture
Vascularity	Whether the nodule is taller than wider	Presence of hilum
Calcification patterns not associated with nodules	Contour	Shape
Pyramidal lobe	Suspicion for extrathyroidal extension/margins	Calcifications
Mediastinal extension	Internal architecture	Vascularity
Tracheal deviation	Echogenicity	Suspicion of invasion of nearby structures/extranodal extension
Thyroglossal duct cyst	Non-suspicious echogenic foci	Overall impression (suspicion of metastasis)
	Calcifications
	Vascularity

Table 2.3

AACE recommendations [5]

Thyroid gland	Thyroid nodule	Lymph nodes
Thyroid parenchyma (homogeneous or heterogeneous)	Number of nodules in each lobe	Purpose of lymph node evaluation
Size in three dimensions	Clinical significance of each nodule	Size in three dimensions
Size of the isthmus	Size in three dimensions	Location
Echogenicity	Location in the gland (both in the superior/inferior and in the anterior/posterior orientation)	Internal architecture
Vascularity	Whether the nodule is taller than wider	Presence of hilum
Calcification patterns not associated with nodules	Contour	Shape
Pyramidal lobe	Suspicion for extrathyroidal extension	Calcifications
Mediastinal extension	Internal architecture	Vascularity
Tracheal deviation	Echogenicity	Suspicion of invasion of nearby structures/extranodal extension
Thyroglossal duct cyst	Non-suspicious echogenic foci	Overall impression (suspicion of metastasis)
	Calcifications
	Vascularity
	Presence of peripheral halo

All three groups recommend measuring the thyroid lobes in all three dimensions.

In addition, at least two of the three guidelines recommend including the description of the gland parenchyma (heterogeneous vs. homogeneous), the general thyroid echogenicity , the vascularity patterns, and the measurement of the isthmus.

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