Thyroid Protocol
- Measure up to 3 thyroid nodules for each lobe.
- If the exam is for parathyroid, take additional grayscale and color cines of the area just posterior to the thyroid using a lower frequency linear probe (the "carotid probe"). Scanning Duration: 15 minutes.
Thyroid Trans
- Show the isthmus at the center with the right and left thyroid lobes.
- If part of thyroid is absent due to thyroidectomy, then change the label accordingly e.g. "Thyroid Bed Sag/Trans" and follow the same protocol below. (Measurements are only taken if the thyroid is present). Color image: One image at midline.
Measurement image: Isthmus A/P width.
Thyroid Trans
Right Thyroid Sag
- Adjust depth and frequency such that the posterior border of the thyroid is visible.
- Take one image of mid sagittal thyroid with measurement. Measurement image: Length and A/P measurements.
Right Thyroid Sag
Right Thyroid Trans
- Take one image of mid transverse thyroid with measurement. Measurement image: Transverse measurement.
Right Thyroid Trans
Right Thyroid Sag Med/Mid/Lat
- Take 3 stills through the thyroid from medial to lateral.
- The medial view should include part of the trachea (alternating hypoechoic and hyperechoic linear bands). Color image: One image at mid thyroid.
Cine: Medial to lateral.
Right Thyroid Sag
Right Thyroid Trans Sup/Mid/Inf
- Take 3 stills through the thyroid from superior to inferior. Color image: One image at mid thyroid.
Cine: Superior to inferior.
Right Thyroid Trans
Right Neck Sag
- One image showing the lateral neck musculature.
Right Neck Trans Level 2-4/5/6
Neck Levels Source: https://commons.wikimedia.org/wiki/File:Cervical_lymph_nodes_and_levels.png
Author: Mikael Haggstrom
CC0 1.0
- Scan through the neck levels in transverse for any abnormal lymph nodes. Refer to this article on the sonographic appearances of malignant cervical lymph nodes.
- Levels 2-4: from the angle of the jaw to the clavicle with the image centered on the carotid artery.
- Level 5: lateral to levels 2-4 with the carotids visible on the far medial side of the image.
- Level 6: from the hyoid (above the thyroid) to the clavicle with the image centered on the thyroid lobe. Cine: Superior to inferior clip each at levels 2-4, 5, and 6.
Left Thyroid Sag
- Take one image of mid sagittal thyroid with measurement. Measurement image: Length and A/P measurements.
Left Thyroid Sag
Left Thyroid Trans
- Take one image of mid transverse thyroid with measurement. Measurement image: Transverse measurement.
Left Thyroid Trans
Left Thyroid Sag Med/Mid/Lat
- Take 3 stills through the thyroid from medial to lateral.
- The medial view should include part of the trachea (alternating hypoechoic and hyperechoic linear bands). Color image: One image at mid thyroid.
Cine: Medial to lateral.
Left Thyroid Sag
Left Thyroid Trans Sup/Mid/Inf
- Take 3 stills through the thyroid from superior to inferior.
- The esophagus is usually seen just posterior to the left thyroid lobe, and should not be mistaken for a nodule. Color image: One image at mid thyroid.
Cine: Superior to inferior.
Left Thyroid Trans
Left Neck Sag
- One image showing the lateral neck musculature.
Left Neck Trans Level 2-4/5/6
Neck Levels Source: https://commons.wikimedia.org/wiki/File:Cervical_lymph_nodes_and_levels.png
Author: Mikael Haggstrom
CC0 1.0
- Scan through the neck levels in transverse for any abnormal lymph nodes. Refer to this article on the sonographic appearances of malignant cervical lymph nodes.
- Levels 2-4: from the angle of the jaw to the clavicle with the image centered on the carotid artery.
- Level 5: lateral to levels 2-4 with the carotids visible on the far medial side of the image.
- Level 6: from the hyoid (above the thyroid) to the clavicle with the image centered on the thyroid lobe. Cine: Superior to inferior clip each at levels 2-4, 5, and 6.
Worksheet
- Print the worksheet containing measurements.