The Neck: Thyroid Gland



10.1055/b-0034-87906

The Neck: Thyroid Gland

























Table 4.52 Enlarged thyroid

Diagnosis


Findings


Comments


Goiter


US: Diffusely enlarged hypoechoic gland with increased vascularity. If multinodular, goiter is enlarged and asymmetrical with several focal nodules of mixed echogenicity.


Correlate with antibody results and NM.


Hemiagenesis


US: unilateral, more common on left.


Due to hypertrophy of single lobe or dysfunction.


Thyroiditis


US: Findings depend on stage, usually diffuse or focal hypoechogenicity and enlargement of both lobes. Doppler shows no increased vascularity.


Clinical signs of thyrotoxicosis in 50%.





























Table 4.53 Thyroid mass

Diagnosis


Findings


Comments


Cyst (usually colloid)


US: hypo-/anechoic mass. If any solid component, requires work-up for thyroid malignancy.


MRI: may appear bright on T1 due to hemorrhage, colloid, or high protein.


Uncommon in young children. True thyroid cysts are rare.


Abscess


Fig. 4.172


US: hypoechoic or anechoic mass, ± internal echoes if infected.


CT: rim-enhancing mass with central low density.


Rare. Suggests congenital pyriform sinus fistula—correlate with barium swallow or fistulogram.


Adenoma


US: Either increased or decreased echogenicity. Classically have hypoechoic halo around isoechoic mass.


Uncommon.


May be single or multiple.


May be hyper- or nonfunctioning.


Carcinoma


Fig. 4.173


US: Primary imaging modality showing either solid or cystic mass usually hypoechoic but may have hyperechoic calcification. Cervical lymphadenopathy seen in 90%.


Rare. Ninety percent are papillary; three-quarters of cases occur in females.


Neck and chest CECT and bone scan are required for staging.

Fig. 4.172 Abscess with a fairly well-defined, hypoechoic mass with internal echoes on transverse US of left thyroid.
Fig. 4.173 Papillary carcinoma with a diffuse solid mass with calcification involving both lobes on transverse US of the thyroid gland.

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Jul 12, 2020 | Posted by in PEDIATRIC IMAGING | Comments Off on The Neck: Thyroid Gland
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