Ultrasound of the thyroid gland
A WORD ABOUT THE THYROID GLAND
The thyroid or thyroid gland (Glandula thyreoidea) is located on the front of the neck is shaped like a butterfly or a shield and is the largest gland with internal hormone secretion. This gland affects almost all metabolic processes in the body, all with the help of its hormones T3 and T4, iodine is necessary for their production.
It is the lack of iodine that leads to a decrease in their production, which further affects the increase in tissue, which leads to a disease popularly known as goiter.
The thyroid gland also secretes calcitonin with the help of its C cells. Calcitonin is important for regulating the concentration of calcium in the blood and it also acts antagonistically to parathormone (parathyroid hormone).
The pituitary hormone TSH (thyroid stimulating hormone) is very important for the functioning of the thyroid gland, i.e. for the metabolism of its hormones T3 and T4. When you do the analysis, this is the reason why the level of this hormone is also controlled.
Because this gland affects so many processes in our body, any change in its work can significantly affect the quality of our life. Stress caused by the speed and intensity of modern life is one of the most frequently cited causes of changes in the functioning of the thyroid gland.
That’s why it’s not surprising to estimate that more than two billion people in the world suffer from some form of thyroid disorder and some indicators show that up to 70 percent of the total population is affected.
It is interesting that today every second woman has one of the thyroid gland diseases and the disease does not choose age – both older and younger women are affected, but also girls, although the majority of female patients are between the ages of 20 and 40. Such statistics are explained by the belief that men take care of their health to a lesser extent than women.
This very common health problem is often very difficult to diagnose or after a long time since the first symptoms appear. It is necessary, on the one hand, for the patient to describe his symptoms carefully, and on the other hand, for the doctor to make an adequate initial diagnosis based on that. Then follows a series of diagnostic methods, among which ultrasound examination of the thyroid gland is one of the most important.
WHICH SYMPTOMS OF THYROID GLAND DISORDER WARN US?
Although our body warns us in many ways that something is wrong with our health we often attribute the symptoms to the natural aging process and the decline of our youthful vigor. Even when the symptoms are quite visible and obvious to experts in the field of endocrinology, patients and often doctors attribute the symptoms of thyroid gland disease to some other diseases.
That’s why it’s important to listen to your body and not ignore some of the following symptoms: a feeling of constant fatigue, weight fluctuations, which means sudden weight loss or gain despite an unchanged diet, sleep problems, feeling of frequent irritability, feeling of swelling, feeling that you have stopped lump in the throat, persistent coughing, menstrual cycle disorder.
It also happens that the symptoms of the thyroid gland are attributed to other diseases, most often heart diseases, because due to the reduced function of the thyroid gland there is a slow heart rate or bradycardia but also an increased heart rate – tachycardia.
Symptoms of thyroid disorders can be classified according to the type of thyroid disease:
- for hyperthyroidism (increased function of the thyroid gland, which implies increased secretion of thyroid hormones) are characteristic: nervousness, irritability, tremors, excessive sweating, rapid heart rate, hair loss, feeling that we are constantly hot, weight loss, more frequent bowel movements in women as well irregular menstrual cycle. All these symptoms are also possible with goiter.
- hypothyroidism (reduced function of the thyroid gland) is characterized by a slowing down of all body functions, almost complete metabolism, which leads to an increase in body weight. Hypothyroidism is directly followed by depression, slower resolution of thought processes, chills, muscle weakness, irregular menstrual cycles. Some patients also have goiter. However, many patients with hypothyroidism have no symptoms, so blood testing is extremely important, but above all, an ultrasound examination.
- Most growths are painless and only noticeable by doctors during an ultrasound examination or during palpation of the patient’s neck. Some larger nodes can be seen during some regular hygiene-aesthetic actions in both men and women. Most nodules in the thyroid gland are painless, but if you feel any kind of pain, it is important to contact your doctor as soon as possible so that the suspicion of the most serious disease of the thyroid gland can be eliminated as soon as possible.
- Cancer of the thyroid gland often does not give any visible symptoms and patients learn about this condition of the organism after ultrasound diagnostics or after magnetic resonance imaging.
- Pain in the neck area, in the place where the thyroid gland is located from the front, occurs very rarely as a symptom, which also applies to hoarseness and difficulty swallowing her.
WHEN IS THYROID ULTRASOUND DONE?
The ultrasound examination method is one of the most widespread diagnostic methods today. This is a painless, safe and simple medical examination for the patient, available today in almost every doctor’s office, both private and state.
In the case of suspected thyroid disease, the primary thing is a clinical examination, not “diagnosis at home”. The doctor-clinician feels the region of the neck and already during this examination he can notice changes that will lead him to further tests in order to establish a final diagnosis. During this examination, the doctor notices and by talking to the patient, learns what symptoms the patient is facing.
In addition to the clinical examination, an ultrasound of the thyroid gland is mandatory. With this examination, changes in the structure of the gland, such as nodules, cysts, chronic autoimmune thyroiditis (HAT) are best diagnosed and a reliable insight into the size and volume of the thyroid gland is obtained. The examination itself includes control of the entire soft tissue of the neck which means that the state of both the thyroid and parathyroid glands, as well as the lymph glands of the neck region, is controlled. All of these glands are located on the lower front of the neck.
It is interesting that parathyroid glands are invisible on ultrasound examination, if they do not have any changes. Only if changes occur in them do they become visible. Visible structural changes in both glands are most often accompanied by disturbances in their function.
There is a misconception that it is not necessary to do an ultrasound of the thyroid gland if the hormones are within normal limits which of course is almost always wrong. An ultrasound examination is a method that will tell us what the regular hormonal status obtained by hormone analysis can “mask”.
In the event that the ultrasound method also includes color Doppler of the thyroid gland and other soft tissues of the neck, then we will have an insight into the extent of blood supply to the glands and their nodes which can indicate disorders and inflammation much more clearly.
Another misconception about ultrasound examinations is that some people believe that they are exposed to radiation during this examination. It is important to point out that this is absolutely not true.
There are certain conditions where there is no doubt as to whether an ultrasound examination of the thyroid gland should be performed and these are:
- Goiter – enlargement of the thyroid gland or the appearance of lumps, nodes, cysts, tumors;
- Problems with sore throat or swallowing problems that last for a long time and are not related to any other health problems;
- When diagnosing and monitoring diseases related to the thyroid gland (Hashimoto’s thyroiditis, hypothyroidism, hyperthyroidism…);
- In case of sudden weight loss or weight gain;
- In unclear febrile conditions
- As a preventive examination in patients who have a genetic predisposition to thyroid disease
ULTRASOUND OF THE THYROID GLAND PERFORMANCE
In order to perform an ultrasound examination, the examination is usually preceded by a clinical examination and an instruction for an ultrasound examination of the thyroid gland, which is scheduled separately.
A thyroid ultrasound can be performed by a doctor specializing in radiology or endocrinology or by a general practitioner trained in ultrasound examinations.
At the beginning of the examination, the patient lies on the examination table. It is necessary to free the neck and the area around the neck from clothing and jewelry. The doctor smears the ultrasound probe with gel, which improves the conductivity of ultrasound waves and eliminates air between the skin of the neck and the ultrasound probe.
Ultrasound of the thyroid gland is a painless examination, which can last from 10 to 20 minutes. The doctor can make an image of certain parts of the thyroid tissue if there are changes or simply make an examination image, which can be used in the further course of diagnosis or treatment.
ULTRASONIC THYROID GLAND PREPARATION
Unlike ultrasound examinations of some other parts of the body, when it is necessary to drink a certain amount of liquid or prepare in a different way for the examination, no preparations are necessary for the ultrasound examination of the thyroid gland.
There is also no specific time of day or month when it is best to do this type of review. Therefore, it is possible to do it at any time, without preparation and this examination is completely painless.
Perhaps the only recommendation is to dress appropriately (certainly not a turtleneck) so that the preparation for the examination (complete opening of the neck) will last as short as possible.
After the examination, the doctor who performed the examination will read the findings to the patient and describe them and of course, if further treatment or consultation of experts from other fields of medicine is needed, the doctor will write an adequate instruction with a report.
WHAT CAN THYROID ULTRASOUND DISCOVER US?
We have already said before how important this examination is for the diagnosis of thyroid gland problems and what makes it a valuable ally in diagnosis is the whole range of information obtained from this examination.
First of all, with this examination, the shape and size of the thyroid gland is observed by measuring the size in three dimensions: length, width and thickness of the gland.
An ultrasound examination can then confirm the existence of nodules (knots) on the gland, which may or may not be visible to the naked eye on the neck. Nodules are actually focal changes, which in most cases are harmless. However, a number of nodules indicate the most serious diseases such as tumors of the thyroid gland.
Ultrasound examination determines the echo structure, i.e. tissue image and its structure. The condition of the lymph nodes and surrounding soft tissues is especially important. During this examination, it is possible to see the cysts, their condition and appearance, shape, edges, size, blood supply, which is very important in order to distinguish whether they are benign cysts (which is most often the case) or malignancy is hidden in them (which is a rarer case).
More advanced ultrasound methods
A classic ultrasound examination of the thyroid gland can determine the status of the thyroid gland as well as other glands in the soft tissue of the neck. The appearance of the gland, its size and the observed changes can tell us a lot and facilitate further diagnosis or treatment. However, there are certain limitations. Here, first of all, we mean that by the appearance of a nodule or cyst, you can only suspect malignancy but most often the final word on this is given by the pathological findings after surgery. It is simply not possible to determine whether it is a benign or malignant tissue change.
With newer generations of ultrasound devices, it is possible to implement a diagnostic method that is a breakthrough in the diagnosis of thyroid gland tumors. This innovative method is called thyroid elastography. This is an ultrasound diagnostic method that shows with a high percentage of success (about 80-100% of cases) whether it is a malignant tumor of the thyroid gland, that is a change or nodule on the thyroid gland or not.
This clinical examination is undoubtedly of great importance in the diagnosis of thyroid cancer as it is a non-invasive and painless method. The principle of this method is based on measuring the resistance of soft tissues to pressure with a probe. In this way, you can see natural changes that seem suspicious.
For now, in order to perform the elastography method, it is necessary to use an ultrasound device of the latest generation.
Who Performs Thyroid Ultrasound?
Thyroid ultrasound can be performed by endocrinologists, radiology specialists or a general practitioner trained in ultrasound examinations.