Diagnostic ultrasound ( PDFDrive )

CHAPTER 19 The Thyroid Gland 717
A
B
C
D
E
FIG. 19.35 Multiparametric Assessment of Thyroid Nodule.
(A) Oval-shaped, isohypoechoic nodule with hypoechoic peripheral
halo. (B) Note peri-intralesional vascularization on three-dimensional
color-Doppler evaluation. (C) The lesion appears mostly soft at
qualitative elastography with low strain ratio (D) and soft at shear
wave elastography (E), conirming its benign nature.
In patients who have undergone a previous thyroid resection
for carcinoma, sonographically guided FNA has become
an important method in the early diagnosis of recurrent or
metastatic disease in the neck (Fig. 19.36). In patients who
have undergone hemithyroidectomy for a benign nodule,
with the detection of one or more foci of occult malignant
tumor in the surgical specimen, ultrasound evaluation of the
contralateral lobe is warranted to exclude the existence of a
residual nodule.
Cervical lymph nodes, both normal and abnormal, can be
readily visualized by high-resolution sonography. hey tend to
lie along the internal jugular chain, extending from the level of
the clavicles to the angle of the mandible, or to be in the region
of the thyroid bed. Benign cervical lymph nodes usually have