Often, how the thyroid gland works is not given much importance. At the same time, the treatment of many diseases can be directly related precisely to deviations in the functioning of this small organ. Thanks to modern technology, it has become possible to study its functioning using ultrasound.
Grounds for holding
In order to prescribe an ultrasound of the thyroid gland, there must be certain grounds or indications. After a patient is interviewed by a doctor to establish an accurate diagnosis, among other studies, it is appointed one of the first. Here is an approximate list of indications for the appointment of ultrasound:
- Difficulty swallowing.
- Swelling in the neck.
- Suffocation.
- Drowsiness, apathy, fatigue.
- Jumps in body temperature for no apparent reason.
- Increased irritability.
- Sudden weight loss or gain.
- Pregnancy planning and age over 40.
- Stop taking oral contraceptives,hormone-containing drugs.
- Irregular heart rhythm, diabetes.
It is also worth paying attention to the deviation from the norms of indicators of such hormones as TSH, T3 and T4. Certain attention deserves the presence of hereditary endocrine diseases. 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 the functioning of vital organs.
Structure of the thyroid gland
The internal structure of the gland looks like an isthmus that connects the two lobes. Visually, some compare its shape with the letter "H" or a butterfly. In some cases, in some patients, ultrasound of the thyroid gland shows that there is an additional lobe in the form of a pyramid, located on top of the isthmus or next to the organ itself.
In children during fetal development, the correct division of the thyroid gland 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 single out 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 experienceQuestion: Do I need special preparation for an ultrasound of the thyroid gland and on which day of the menstrual cycle is it better to approach? The answer is this: no matter what day is on the calendar, the study is carried out without special requirements. Hormones have no effect on the structure and structure of the thyroid gland.
Before taking a child to a study, parents must explain to him in advance what it will consist of and what it is for. Of course, if a child, due to his age, can understand an adult. It is better to tell in advance how an ultrasound of the thyroid gland is done and, most importantly, that it does not hurt at all. An hour and a half before the examination, 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 thyroid gland.
Before the study, the doctor should tell you about the essence of conducting and preparing for an ultrasound of the thyroid gland. If the procedure is carried out in a local clinic, then you need to take a diaper and a towel, water with you. 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 it all with you.
How is ultrasound performed in adults
Like most studies, thyroid ultrasound is done in a horizontal position. The patient must undress 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 limit himself to measuring general parameters (length, width, thickness of the lobes of the organ).
Otherwise, the study of neoplasms, changes, determining their size, identifying the cause (if possible to visualize) may take more time. If we talk about standard procedures, they last approximately 10-15 minutes.
How is thyroid ultrasound performed in children
Tyroid ultrasound in children is no different from adults. It is worth noting that many people tolerate this study much easier than other planned procedures. Despite the absence of specific requirements, before the study, children first of all need to create an atmosphere of trust in the doctor and calmness. An adult should 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 diagnostician, in rare cases by the attending physician. The study takes place in the supine position, the child needs to expose the neck area. Further manipulations do not differ from the ultrasound of adults. It is allowed to take the child in your arms or put him on yourself.
What do they 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 will be able to choose the right treatment regimen in the future.
Parameters that people pay attention to first of all:
- Structure of the thyroidgland.
- Determination of the volume of its shares, as well as linear parameters.
- Blood supply, including using Doppler, which allows you to determine the degree of blood saturation of individual parts of the thyroid gland.
- Presence of formations, tumors, cysts, abscesses, nodes.
- Swollen lymph nodes.
- Presence of calcifications.
Private medical centers take photos of problem areas after thyroid ultrasound, which helps the doctor to visually examine them and prescribe the right treatment.
What is considered normal in diagnostics
When the diagnostician starts to touch the patient's neck with the sensor, then on the monitor he should see a clear picture in any area. When an ultrasound of the thyroid gland is done, the norm is defined as a homogeneous structure, without echogenic inclusions, blackouts, all areas have the same color.
It is worth mentioning separately the volumes of the organ, which are taken into account depending on the gender and age of the patient:
- Children aged 6 to 10 - 8 ml.
- Teenagers from 11 to 14 years old - 10 ml; from 15 to 18 years - 15 ml.
- Women over 19 - up to 18 ml.
- Men over 19 - up to 25 ml.
If an ultrasound examination is performed on a child or adolescent, their age should be taken into account. Since during the period of intensive growth, changes occur in the thyroid gland. Girls tend to have less than boys.
If we talk about size standards for ultrasound of the thyroid gland, the transcript should contain the following values:
- Width - 1-1.8 cm.
- Length - 2.5-6 cm.
- Thickness - 1.5-2 cm.
In some people, the 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 the ultrasound of the thyroid gland, no neoplasms and excess of its size should be detected. Calcifications and nodes no more than 1-3 cm are also considered within the permissible limits. If they exceed these values, then there is a danger of developing a malignant tumor. To clarify the diagnosis, a biopsy may be required to determine the nature of the neoplasm.
What deviations from the norms say
If a doctor diagnoses a deviation from the norm on an ultrasound of the thyroid gland towards an increase, then this may indicate the development of diseases such as:
- Thyroiditis - is formed as a result of an inflammatory process, which in most cases does not change the structure of the thyroid gland, however, the gland can be enlarged due to the presence of inflammation. It is customary to distinguish between autoimmune, silent 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 manifest itself 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 thegland.
- Tumor, cancer, adenoma - if they are malignant, the contours will be fuzzy, with germination into neighboring tissues. Benign ones are separated from he althy areas, have a dense structure. It is possible to finally determine the nature of the neoplasm only after taking a biopsy.
Lack of timely treatment of thyroiditis can lead to the development of a purulent process and further to hypothyroidism. If measures are taken in time, after its treatment, nodes remain or, with sizes less than 1 cm, focal formations. Deviations from the norm, which show that there is a decrease in the size of the thyroid gland on ultrasound, may be the reason for antitumor therapy as a result of damage to the pituitary gland or hypothalamus. Acceptable are considered if the thyroid gland is less than ¼-⅓ of the norm. However, its functions do not suffer from this.
Fuzzy contours of the thyroid gland 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 procedure, ultrasound of the thyroid gland may reveal cysts. 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, then in the decoding of the ultrasound of the thyroid gland may indicate the presencehyperechoic area. In order to confirm the diagnosis during a second examination or during the same procedure, the doctor additionally resorts to elastography. It allows you to diagnose the nature of benign and cancerous formations. At the same time, they are characterized by the following features: fuzzy contours, vertical dimensions larger than horizontal ones, vessels inside the node are visualized on the monitor. This most often indicates that the tumor is malignant. However, they can also be found in benign neoplasms.
When the cyst does not cause inconvenience or discomfort, choose the observational method of therapy. Otherwise, it can interfere with swallowing, squeeze the tissues, and then a decision is already made to remove it.
Ultrasound during pregnancy
Women who are pregnant undergo a lot of research. If even before the onset of pregnancy there were problems in the functioning of the thyroid gland, an indication for ultrasound may be justified, as it allows timely prevention of deterioration in he alth. Timely diagnosis using this method is considered safe and has no contraindications even in such a period. However, even if there were no problems in the work of the thyroid gland before, then if disturbing symptoms are detected, you should consult a doctor.
The grounds for the diagnosis can be all of the above reasons, as well as the presence of seals during palpation of the organ. Size increases are allowed.from the norm by more than 16%, which is explained by the increased load on the work of the gland during pregnancy.
Timely diagnosis reveals a decrease in hormones produced by organisms, which is fraught with a deterioration in the general well-being of a pregnant woman. In this connection, she may have mood swings, an unreasonable 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 neoplasms present in it. Echogenicity is commonly understood as the ability of tissues to reflect the ultrasonic waves of the transducer. There are four types in total:
- Hyperechoic - full reflection of ultrasound waves, the studied areas have a light tone, characteristic of the connective tissue in the thyroid gland.
- Hypoechoic - in which the transducer waves are weakly reflected, the presence of dark areas may indicate nodes with fluid or cysts. Doppler is used to clarify their structure. In the case when the neoplasm around has a dark spot, it is necessary to exclude a cancerous tumor.
- Isoechogenic - partial reflection of ultrasound waves, on the monitor isoechoic areas are tinted with gray. As a rule, this substance is gel-like in composition, contained in colloids.
- Anechogenic - ultrasonic waves are completely absorbed, and are painted black on the monitor. Most likely, these can be blood vessels, nodes containing fluid, infiltrates. In most cases, these neoplasms are benign.
If the firstof two types, an endocrinologist should conduct additional studies and tests in order to establish an accurate picture of the disease.
At the end of the diagnosis, the specialist reflects the data obtained in the protocol of ultrasound of the thyroid gland. This conclusion cannot serve as a basis for a definitive diagnosis. This is the prerogative of the attending endocrinologist. Since only he has in his hands 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.
