Thyroid Ultrasound and Ultrasound-Guided FNA Biopsy

Book excerpt: Over the past two decades ultrasound has undergone numerous advances in technology such as gray-scale imaging, real-time sonography, high resolution 7.5-10 MHz transducers, and color-flow Doppler. This makes ultrasound unsurpassed in its ability to provide very accurate images of the thyroid gland quickly, inexpensively, and safely. However, in spite of these advances, ultrasound remains drastically underutilized by endocrinologists. In part, this is due to a lack of understanding of the ways in which ultrasound can aid in the diagnosis of various thyroid conditions and to a lack of experience in the ultrasound technique by the clinician. Thyroid Ultrasound and Ultrasound-Guided FNA Biopsy presents a `hands-on' approach to using ultrasound in the clinical evaluation and management of thyroid disease. It is written specifically for the clinician and discusses the subtleties one needs to be aware of in using this technique. Particular attention is paid to using ultrasound in conjunction with FNA biopsy. New technology such as three-dimensional ultrasound, color-flow Doppler, and percutaneous injection of cysts and nodules are discussed and demonstrated. Numerous ultrasound examples are used to show the interactions between ultrasound and tissue characteristics and explain their clinical significance. Also presented is the work of several groups of investigators worldwide who have explored new applications of ultrasound, that has led to novel techniques that are proving clinically useful.