Notes
  • There is no convention on the order in which nodule or thyroid size measurements are reported (i.e. transverse, AP, or longitudinal). In this rubric, measurements are given transverse × longitudinal (superior to inferior) × AP
  • Images in this activity are scaled to 100 pixels per centimeter; assessment should allow for a reasonable margin of error in measurements

Question 1

  • The overall thyroid gland has heterogeneous parenchyma
  • Diffuse distribution of blood flow throughout the gland
  • Right lobe 1.84 × 5.43 × 1.71 cm
  • Left lobe 1.99 × 3.89 × 1.89 cm
  • Isthmus: 0.37 cm
  • Left lobe nodule:
    • Hypoechoic, anterior, 2.05 × 3.31 × 0.91 cm
    • Well-defined margins
    • Peripheral and central blood flow
    • No calcifications
    • Wider than tall

Question 2:

  • Overall homogenous background parenchyma of the thyroid
  • Right lobe: 3.74 × 4.62 × 2.68 cm
  • Isthmus 0.18 cm
  • Left lobe: 1.1 × 3.08 × 0.83 cm
  • Right cyst takes up almost the entire right lobe:
    • Measures 2.91 × 3.61 × 1.63 cm
    • Mostly cystic with a small amount of solid material peripherally
    • Blood flow peripherally, and a small amount of blood flow in the solid portion
    • Well-defined margins
    • No calcifications

Question 3:

  • Background parenchyma homogenous
  • Right lobe: 2.52 × 4.91 × 2.52 cm
  • Isthmus 0.57 cm
  • Left lobe 2.47 × 5.5 × 1.53 cm
  • Right nodule:
    • Isoechoic, posterior, 2.08 × 3.49 × 2.11 cm
    • Coarse calcification with posterior shadowing
    • Ill-defined borders
    • Peripheral blood flow with small amount of central blood flow
  • Left nodule:
    • Spongiform, 1.71 × 1.57 × 1.37 cm
    • Peripheral blood flow
    • No calcifications
    • Ill-defined borders 

Question 4:

  • Overall background echotexture homogenous
  • Right lobe 2.84 × 4.04 × 2.66 cm
  • Isthmus 0.18 cm
  • Left lobe 1.08 × 3.69 × 0.72 cm
  • Right thyroid nodule:
    • Takes up almost the entire right lobe
    • Isoechoic
    • Well-defined borders
    • No calcifications
    • Peripheral and central blood flow
    • Wider than tall, 2.4 × 3.19 × 2.0 cm

Question 5:

  • Overall very heterogeneous gland; difficult to discern one nodule from another
  • Right lobe: 1.76 × 3.84 × 1.87 cm
  • Isthmus 0.17 cm
  • Left lobe 1.77 × 3.46 × 1.88 cm
  • Right nodule:
    • In transverse view appears as 1 nodule, in longitudinal view appears to have a superior and inferior nodule
  • Right inferior: 1.76 × 1.75 × 1.24:
    • Hypoechoic
    • Ill-defined margins
    • Microcalcifications
    • Central and peripheral blood flow
  • Right superior: 1.76 × 1.61 × 1.29 cm:
    • Hypoechoic
    • Ill-defined margins
    • Microcalcifications
    • Central and peripheral blood flow, and heterogeneous
  • Left nodule:
    • Hypoechoic
    • Partially solid and partially cystic
    • Microcalcifications
    • Lobulated
    • Peripheral blood flow