Korean J Radiol.  2011 Feb;12(1):1-14. 10.3348/kjr.2011.12.1.1.

Ultrasonography and the Ultrasound-Based Management of Thyroid Nodules: Consensus Statement and Recommendations

• Moon WJ
• Baek JH
• Jung SL
• Kim DW
• Kim EK
• Kim JY
• Kwak JY
• Lee JH
• Lee JH
• Lee YH
• Na DG
• Park JS
• Park SW
• Korean Society of Thyroid Radiology (KSThR)
• Korean Society of Radiology

• KMID: 991677
• DOI: http://doi.org/10.3348/kjr.2011.12.1.1

Abstract

The detection of thyroid nodules has become more common with the widespread use of ultrasonography (US). US is the mainstay for detecting and making the differential diagnosis of thyroid nodules as well as for providing guidance for a biopsy. The Task Force on Thyroid Nodules of the Korean Society of Thyroid Radiology has developed recommendations for the US diagnosis and US-based management of thyroid nodules. The review and recommendations in this report have been based on a comprehensive analysis of the current literature, the results of multicenter studies and from the consensus of experts.

Keyword

Thyroid, US; Thyroid, neoplasms; Thyroid, aspiration biopsy

MeSH Terms

Biopsy, Fine-Needle
Diagnosis, Differential
Humans
Thyroid Gland/pathology/ultrasonography
Thyroid Neoplasms/pathology/ultrasonography
Thyroid Nodule/pathology/*ultrasonography
Ultrasonography, Interventional

Figure

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  Fig. 1 Internal content of thyroid nodules. A. Solid B. Predominantly solid C. Predominantly cystic D. Cystic

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  Fig. 2 US findings of spongiform appearance are shown Transverse US image of benign nodular hyperplasia shows well-defined smooth isoechoic mass with a spongiform appearance (arrows).

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  Fig. 3 Shape of thyroid nodules. Corresponding schematic drawings are shown in upper panel. A. Ovoid-to-round shape B. Taller-than-wide shape C. Irregular shape

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  Fig. 4 Margin of thyroid nodules. A. Smooth margin B. Spiculated or microlobulated margin (arrow) C. Ill-defined margin (arrows)

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  Fig. 5 Echogenicity of thyroid nodules. A. Marked hypoechogenicity of nodule is shown. Note more hypoechoic nature of nodule (arrow) as compared to that of strap muscles (asterisk). B. Hypoechogenicity of nodule (arrows) C. Isoechogenicity of nodule (arrows) D. Hyperechogenicity of nodule (arrow)

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  Fig. 6 Calcifications of thyroid nodules. A. Microcalcification within nodule as echogenic focus B. Macrocalcification (arrow) in center of nodule (white triangles) C. Rim calcification in small nodule (calipers).

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  Fig. 7 US elastography of thyroid nodules. A. Elastography shows nodule with hard consistency as blue relative to green background. B. Longitudinal US image shows same nodule with suspicious malignant US features. Nodule was proven to be papillary carcinoma.

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  Fig. 8 Flowchart for strategy for follow-up US and US-guided fine needle aspiration (USFNA) biopsy according to US findings and cytology results of thyroid nodules. Dotted arrow means that surgery is not strongly recommended, but it can be considered according to individual situations. AUS = atypia of undetermined significance, FLUS = follicular lesion of undetermined significance.

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