Ultrasound is the imaging modality of choice when evaluating the thyroid. It is a safe, painless, and non-invasive procedure. The procedure uses high frequency sound waves to produce images of thyroid and other organs inside your body.
Ultrasound provides excellent anatomic detail and plays a vital role in current clinical practice; with accurate diagnosis ultrasound significantly improves the management of numerous medical conditions.
The thyroid is a gland situated at the front of the neck. It consists of two lobes that lay on either side of the windpipe (trachea) and are connected by a strip of thyroid tissue called the isthmus. The thyroid gland is an endocrine gland that produce and release hormones into the bloodstream.
What happen during my scan?
For thyroid scan there is no particular preparation needed. You just to expose your neck. You will be examined in a semi-sitting position with your chin upwards. A high frequency linear transducer array will be used to provide a high-resolution image. Grey scale and colour doppler ultrasound are used to evaluate a thyroid lesion. The size, form, borders, echogenicity, contents, location and vascular pattern of the whole thyroid gland will be assessed. In some cases, a fine needle aspiration biopsy might be recommended when further investigations needed.
Can ultrasound detect any nodules in my thyroid?
Ultrasound has become an essential diagnostic technique in the examination of thyroid nodules. It is highly sensitive in detecting nodules, the sonographic features and
whether they are benign nodules or if they have malignant characteristics that require further investigation such as a biopsy. If a biopsy is necessary, Fine needle aspiration (FNA) can help to improve the accuracy of diagnosis.
What is a thyroid nodules?
Thyroid nodules are categorized according to the “U” classification by the British thyroid association. Under this classification, Nodules are classified into categories (U1-U5) based on features including the echogenicity, margins, internal echo pattern, calcification, and vascularity. (U1) indicates a normal thyroid. A benign thyroid nodule is indicated by (U2). A U3 nodule is indeterminate/equivocal. (U4) indicates a suspicious nodule and (U5) indicates malignancy. U3-U5 nodules require FNA to be performed.
What else can be detected in my thyroid scan?
Thyroid ultrasound is also used to evaluate diffuse changes in thyroid parenchyma. Hashimoto thyroiditis and Graves’ disease are common disorders that present diffuse thyroid enlargement. Hashimoto thyroiditis is an autoimmune disease where the immune system attacks the thyroid gland therefore the thyroid is unable to produce enough hormones. Graves’ disease is another autoimmune disorder that causes the thyroid to become overactive and produce excess thyroid hormones thus several body functions work faster than usual.
Ultrasound is the first line imaging modality for the evaluation of testicular abnormalities. It is safe, painless, and reliable means of showing testicular anatomy, locating testicular masses and assessing their vascularity.
Why do I need testis ultrasound (Scrotum ultrasound)?
Scrotal pain, swelling or a palpable lump are common signs and symptoms upon clinical examinations. A testicular ultrasound is used to obtain images of the testicles and the surrounding area in the scrotum. Ultrasound can distinguish a testicular mass from an extra testicular mass as well as whether a mass is cystic, solid, or complex. It is also capable of distinguishing between a benign and malignant lesion.
What happen during my scan?
There is no particular preparation for this scan. you will be asked to bring down your trousers and underwear. The testicles and scrotum are lifted, and a paper towel is placed underneath to support the scrotum. The patient holds another paper towel to cover the penis and holds it against the abdominal wall. A high-frequency linear transducer is used to obtain images of the structures in your testis.
What is Epididymitis and epididymo-orchitis?
Acute scrotal pain is a common sign of Epididymitis affecting adolescent boys and male adults. It is usually caused by a bacterial infection such as lower urinary tract infections (UTI) and sexually transmitted disease (STD). Symptoms can include fever, dysuria and discharge. When the bacterial infection is spread to the testes, this is known as epididymo-orchitis.
Other abnormalities which can be detected by ultrasounds are :
Testicular trauma is most encountered after injury such as a car accident or sports injury. Ultrasound evaluation of an injured testicle is critical in deciding whether prompt surgical intervention is required. Fluid collections (hydrocele, haematocele or hematoma), testicular rupture and vascular injury can be signs of testicular trauma.
Testicular torsion is a condition where the testicles twist around the spermatic cord, therefore, cutting off the blood supply causing pain and swelling. It is more common in younger boys between the ages of 12 and 18. Immediate diagnoses is required, as delaying it can cause the loss of testes.
Varicoceles is the most frequent palpable mass. They develop when blood flow from the spermatic cord is impaired, producing abnormal dilatation of the pampiniform plexus veins. The pampiniform plexus veins usually measure 0.5 to 1.5 mm in diameter and veins that are greater than 3mm are considered to be abnormal. Cases of Idiopathic varicocele is caused by impaired draining of blood. Secondary varicocele occurs due to an increase of pressure in the testicular vein which is caused by various conditions such as hydronephrosis, obstruction from a pelvic or abdominal mass or obstruction such as renal vein thrombus.
Hydrocele is the significant accumulation of fluid within the thin sheath that surrounds the testicles. It is the most common cause of painless scrotal swelling. Hydroceles can be congenital or acquired. Acquired hydrocele could be idiopathic due to overproduction or because of impaired fluid absorption. Hydroceles can also be caused secondary to trauma, infection, torsion, or tumour.
Microlithiasis is a condition that causes tiny clusters of calcium to develop in the testicles. Microcalcifications in the testes are uncommon and usually discovered incidentally. it is asymptomatic and does not cause any pain. Microlithiasis has been shown to be associated with testicular neoplasms. Patients presenting with microcalcifications are advised to undergo annual ultrasound scans, particularly if they are symptomatic.
Simple testicular cysts are a common incidental finding. Their cause is usually unkown. However, they may appear as a result of previous inflammation or trauma. An epididymal cyst is found in the epididymis. These cysts are clinically insignificant unless they are symptomatic, and no treatment is required. An epidermoid cyst is the most common benign testicular mass. They can present as a mass or usually an incidental finding on sonographic examination.