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Normal thyroid ultrasound

Normal adult thyroid volume is ~10-15cc . Transverse US scan of normal thyroid/neck . Longitudinal US scan of normal thyroid/neck superior inferior superior inferior . Thyroid Ultrasound in the diagnosis of thyroid nodules . Mazzaferri, N Engl J Med 1993 Prevalence of thyroid nodules in the US Ultrasound/autops ULTRASOUND OF THE THYROID - Normal It is a superficial gland which should be homogeneous in it's echotexture. There are 2 sides of the gland with an isthmus joining the left and right sides. Thyroid function tests explaine

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Thyroid Normal - Ultrasoundpaedi

In thyroid hormone resistance, thyroid hormone levels (TSH, T4, and T3) are normal, but cellular resistance creates thyroid dysfunction. This thyroid disorder is difficult to pinpoint because it doesn't show up on tests A normal ultrasound of the thyroid gland is demonstrated. Image a and b are sagittal images, image c is a transverse view of both lobes and the isthmus, and image d and e are individual measurements of the right and left lobe respectively.

Thyroid ultrasound - PubMed Central (PMC

  1. e if a nodule is solid or fluid filled (cystic), and it can deter
  2. Menken KU, Engelhardt S, Olbricht T. [Thyroid gland volume and urinary iodine excretion in children 2-16 years of age]. Dtsch Med Wochenschr 1992;117:1047-51. Perry RJ, Hollman AS, Wood AM, et al. Ultrasound of the thyroid gland in the newborn: normative data. Arch Dis Child Fetal Neonatal Ed 2002;87:F209-11
  3. Thyroid ultrasound testing is the most common way to visualize or look at your thyroid gland (1). Your thyroid gland is a relatively small organ that sits at the base of your neck and it produces some very important thyroid hormones. Certain conditions (such as cancer, nodules and autoimmune disease) may cause irregularities in your thyroid gland
  4. e the thyroid gland. It can be used to help diagnose a wide range of medical conditions affecting the thyroid gland, including benign thyroid nodules and possible thyroid cancers. SerhiiBobyk/ iStock/Getty Images Plus/ Getty Image
  5. The two preoperative thyroid ultrasound images showing a well-cir-cumscribed, solid lesion with heterogeneous echotexture. The mass was 2.4 cm (longitudinal) × 1.9 cm (anteroposterior) × 1.9 cm (transverse). A thyroidectomy was performed in the patient, and 15 lymph nodes in her neck were dissected from the central compartment of the neck

The thyroid gland often undergoes anatomical changes when it is not functioning correctly. Ultrasounds are quick, painless, and often inexpensive studies that can reveal a lot of information about your thyroid gland. Why you may need a thyroid ultrasound. Chances are, your doctor will order an ultrasound of your thyroid shows signs of disease Uses for a thyroid ultrasound A thyroid ultrasound may be ordered if a thyroid function test is abnormal or if you doctor feels a growth on your thyroid while examining your neck. An ultrasound can.. Ultrasound. It is difficult to reliably sonographically differentiate Hashimoto thyroiditis from other thyroid pathology. Ultrasound features can be variable depending on the severity and phase of disease 1,5: diffusely enlarged thyroid gland with a heterogeneous echotexture is a common sonographic presentation (especially initial phase) The average size of the thyroid lobules assessed sonographically was 2.3 x1.6 x 0.8 mm (length, width, height). Normal parathyroid glands can be identified using high-resolution ultrasonography The normal thyroid gland is uniformly echogenic relative to the overlying strap muscles of the neck ( Fig. 1 ). A thyroid nodule is defined as a region of parenchyma sonographically distinct from the remainder of the thyroid and located within the confines of the echogenic thyroid capsule

The TSH level is usually normal in thyroid cancer. T3 and T4 (thyroid hormones) These are the main hormones made by the thyroid gland. Levels of these hormones may also be measured to get a sense of thyroid gland function. The T3 and T4 levels are usually normal in thyroid cancer. Thyroglobulin. Thyroglobulin is a protein made by the thyroid gland A thyroid ultrasound is an imaging method to see the thyroid, a gland in the neck that regulates metabolism (the many processes that control the rate of activity in cells and tissues). How the Test is Performed Ultrasound is a painless method that uses sound waves to create images of the inside of the body Thyroid function tests. Tests that measure blood levels of thyroid-stimulating hormone (TSH) and hormones produced by your thyroid gland can indicate whether you have hyperthyroidism or hypothyroidism. Ultrasound. This imaging technique uses high-frequency sound waves to produce images of your thyroid gland

Ultrasound imaging showed a normal orthotopic thyroid with normal sized lobes and isthmus. However, just above then isthmus, just to the left of midline, a complex mass was seen on sonography. The larger cystic area of 3 cms. was seen to contain a papilliform growth bulging into the cystic area Sonographic recognition of alterations in fetal thyroid dimensions may be the first sign of thyroid dysfunction, permitting early diagnosis and intervention. The main goal of this study was to build curves with reference values for ultrasound measurements of the fetal thyroid from 14 to 40 weeks of gestation Thyroid ultrasound is a promising but relatively underused technique for thyroid imaging in newborn infants with congenital hypothyroidism. 10 As far as we are aware, no data exist to indicate whether thyroid size is best expressed in terms of linear measurements or volume. 11 However, in both the paediatric and adult literature, thyroid size.

Bronchietasis is defined by a bronchus-to-artery ratio of >1.2 on chest radiographs 1§. § Based on the external diameters of both the pulmonary arteries and bronchi on chest radiographs. Normal bronchi are not usually seen in the most peripheral 5 to 10 mm of the lung on CT 2. References: 1. Woodring JH. Pulmonary artery-bronchus ratios in patients with normal lungs, pulmonary vascular. An ultrasound of the thyroid produces pictures of the thyroid gland and the adjacent structures in the neck. The thyroid gland is located in front of the neck just above the collar bones and is shaped like a butterfly, with one lobe on either side of the neck connected by a narrow band of tissue Ultrasound can help evaluate a thyroid nodule and determine the need for biopsy. A thyroid fine needle aspiration biopsy can collect samples of cells from the nodule, which, under a microscope, can provide your doctor with more information about the behavior of the nodule

Ultrasound Findings. Normal thyroid and parathyroid glands: (Blum, 2016) (Chaudhary, 2013) Normal thyroid lobe dimensions are: 18-20 mm longitudinal and 8-9 mm antero-posterior (AP) diameter in newborn; 25 mm longitudinal and 12-15 mm AP diameter at one year age; and 40-60 mm longitudinal and 13-18 mm AP diameter in adult population The remaining thyroid tissue rarely causes a diagnostic problem if we have information regarding the type of surgery performed on a patient. Remaining thyroid tissue appears as the normal thyroid parenchyma did be-fore any additional treatment or if there was no underlying parenchymal disease such as thyroiditis [13]. With radioactive ablatio Thyroid nodules or the thyroid gland -- In this test, a needle draws out a small amount of tissue from the nodule or thyroid gland. This is a test to diagnose thyroid disease or thyroid cancer. The parathyroid gland. Lymph nodes in the area of the thyroid. Normal Results. A normal result will show that the thyroid has a normal size, shape, and. A thyroid ultrasound is an imaging method to see the thyroid, a gland in the neck that regulates metabolism (the many processes that control the rate of activity in cells and tissues). Thyroid ultrasound is a sound wave picture of the thyroid gland taken by a hand-held instrument and translated to a 2-dimensional picture on a monitor Ultrasound is the first-line imaging modality for assessment of thyroid nodules found on clinical examination or incidentally on another imaging modality. This article is an overview of ultrasonographic features of thyroid nodules, which are used to determine the need for biopsy with fine needle aspiration.Specific management guidelines from various professional societies are covered in.

Thyroid gland Radiology Reference Article Radiopaedia

Darker than normal: Ultrasound shows differences in density of thyroid nodules. They many times seem darkerthan normal thyoid tissue. Sometimes you can see increased amou Read More. 1 doctor agrees. 0. 0 comment. 2. 2 thanks Got thyroid ultrasound and it said: The right lobe of the thyroid measures 5.6 x 2.4 x 1.9 cm and is heterogeneous. The thyroid isthmus measures 7 mm. The left lobe of the thyroid measures 5.0 x 1.8 x 1.8 cm and is heterogeneous. PROMINENT HETEROGENEOUS THYROID GLAND WITHOUT FOCAL NODULE The ultrasound will also show the size and number of nodules on your thyroid. Radioiodine Scan This test uses radioactive iodine which will be taken up by thyroid cells The thyroid ultrasound is a method used to check the size, position and shape of the thyroid gland. This method helps in diagnosing any underlying disorder. For e.g., if the doctor does not observe normal size of thyroid gland on ultrasound, he may check for the presence of conditions like goiter, tumor or cysts

A heterogeneous thyroid gland means that the gland is abnormal, according to the Research Institute of Radiological Science. A normal, or homogeneous, thyroid has uniform tissue throughout. An abnormal thyroid gland often presents with nodules, which may or may not be cancerous. Most thyroid nodules are benign, according to both the Research. Overview of normal thyroid ultrasound/Doppler-ultrasound. The normal thyroid gland is in the neck's infra-hyoid visceral space . It produces the hormones T3 and T4, which have well-known important roles in growth and metabolism regulation. The normal thyroid parenchyma is divided in multiple lobules, each one composed of 20 to 40 follicles. recovery phase. Most patients recover normal thyroid function within a year, but these patients have a higher risk of developing hypothyroidism afterwards. Ultrasound findings include a diffusely hypoechoic gland or multiple hypoechoic foci in the thyroid parenchyma [15]. A B Figure 2: Thyroid abscess, diagnosed by FNAB Thyroid ultrasound should not be routinely performed in patients with normal thyroid on physical examination. The 2 most common indications for thyroid ultrasound are briefly summarized below. Ultrasound and Thyroid Nodules. Thyroid nodules are a common clinical problem found on physical examination in 3-7% of the population

Intelligent Diagnosis of Thyroid Ultrasound Imaging Using an Ensemble of Deep Learning Methods. Medicina (Kaunas). 2021 Apr 19;57 (4):395. doi: 10.3390/medicina57040395 This 37 year old female presents with single nodule in the left lobe of the thyroid. Ultrasound of the mass in sagittal (a) and transverse view (b) reveals a complex mass with isoechoic and hypoechoic nodular components. The normal thyroid tissue is seen superiorly in image a and medically in image b

In this chapter are presented ultrasound characteristics of normal thyroid gland—echotexture, echogenicity and color flow Doppler sonography patterns. A thyroid lobe has the shape of the rotation ellipsoid. Method of Brunn is widely used to calculate thyroid volume (Tvol) as a sum of the two lobes each calculated according to the following. Thyroid Ultrasound Thyroid ultrasound refers to the use of high frequency sound waves to obtain an image of the thyroid gland and identify nodules. It tells if a nodule is solid or a fluid-filled cyst, but it will not tell if a nodule is benign or malignant An ultrasound scan of the thyroid is used to evaluate lumps or nodules. Nodules. small swellings or aggregation of cells in the body, especially an abnormal one. found on or near the thyroid gland. It can be used to establish if the mass is connected to the thyroid itself or another part of the body. An ultrasound scan cannot diagnose an.

Thyroid / Head and Neck UW Ultrasoun

  1. ing the thyroid gland. A thyroid ultrasound also has the benefit of being non-invasive, it doesn't use ionizing radiation, and it is less expensive than other imaging techniques such as an MRI and CT scan
  2. An introductory video into learning thyroid anatomy using ultrasonography. Intended for limited viewing by medical students
  3. A thyroid ultrasound may be used to identify thyroid nodules. If any nodules are found, the ultrasound can provide insight as to whether they are solid or cystic (fluid-filled) nodules, both of which are require different modes of treatment. Ultrasound can also be used to monitor any growth or changes to the nodules over time

A Neck/Thyroid Ultrasound allows for the evaluation of the thyroid and parathyroid glands and other soft tissues in the neck to determine the cause of the lump or if further testing and possibly a biopsy is required. Even if the nodules are determined to be non-cancerous, your physician may recommend regular Neck/Thyroid Ultrasounds to monitor. Up until this year, everything has come back within normal parameters. 4 weeks ago, I had a thyroid panel pulled and my results were as followed: T4 Free: 0.5 (reference range 0.6 - 1.5) LOW TSH 3rd Gen: 1.386 (reference range 0.400 - 4.200) NORMAL. Today, a more thorough panel was pulled Hi, I am a 21 year old female who was recently diagnosed with hyperthyroidism through blood tests. My doctor is sending me to see an endo but, I can't get in until July so, in the mean time I was having a few problems so, he did a thyroid ultrasound. He called and said the ultrasound was normal so there are no tumors or growths

On sonography, a thyroid gland affected by Hashimoto thyroiditis typically has a diffusely altered parenchyma. The thyroid is often enlarged and hypoechoic with a heterogeneous echotexture and echogenic septations [2-6]. The decreased echogenicity is a result of lymphocyte infiltration and often correlates with hypothyroidism . In the present. In case you're wondering, I've been diagnosed due to my obviously hypo symptoms and a thyroid-ultrasound. It showed a total thyroid size of only 5.5 ml (for males over here in europe the normal range is between 18 - 25 ml) and excessive perfusion of my thyroid (all red and yellow on the ultrasound), which is a clear sign of inflammation The mono screening was negative, all of my blood work was within normal testing parameters (I have the numbers, if anyone needs them). My TSH was at 2.36 (FINALLY) and my Free T4 was 1.31. I went for the Thyroid Ultrasound on Thursday, and the doc just called to say that it was normal - no nodules or anything Normal parathyroid glands are often difficult to see on ultrasound, but abnormal parathyroid glands may be enlarged and can be easily examined through ultrasound. During a parathyroid ultrasound, a handheld instrument called a transducer is passed back and forth over the neck to form a picture of the thyroid and parathyroid glands Knowledge of the normal and abnormal imaging appearances of the thyroid gland is essential for appropriate identification and diagnosis of thyroid lesions. Thyroid nodules are often detected incidentally at computed tomography, magnetic resonance imaging, and positron emission tomography; however, ultrasonography (US) is the most commonly used.

Ultrasound Evaluation of the Thyroid Training Video is designed to provide a comprehensive overview of the thyroid and parathyroid anatomy/physiology, scan protocols, normal ultrasound characteristics and abnormal findings associated with commonly seen thyroid pathology. Date of Original Release: 3/26/2019 All thyroid functions were normal in fact right in the middle of normal. Then a thyroid scan was ordered which showed a normal thyroid size and that neither nodules was dominant, hot or cold, and that the thyroid uptake was slightly elevated 36% at 6 hours and 18% at 24 hours. I have three relatives all on the same side with thyroid cancer at. A hormone called TSH (Thyroid Stimulating Hormone) is checked to get a sense of overall thyroid activity. TSH is not actually made in the thyroid, but it helps regulate the production of other thyroid hormones. Most patients with thyroid cancer will have normal TSH levels. Blood samples will also be checked for T3 & T4 (the metabolism. An office thyroid ultrasound was performed that showed a thyroid of normal size with an isoechoic nodule with an indistinct border in the left lobe that measured 0.9 cm x 0.8 cm x 0.8 cm (sagittal.

Background . Adequate thyroid function is essential for normal growth and development of the fetus. Sonographic recognition of alterations in fetal thyroid dimensions may be the first sign of thyroid dysfunction, permitting early diagnosis and intervention. The main goal of this study was to build curves with reference values for ultrasound measurements of the fetal thyroid from 14 to 40 weeks. Find out if the thyroid gland is too large. A thyroid ultrasound may also be used to keep track of the size of the thyroid gland during treatment for a thyroid problem. Guide the placement of the needle during a thyroid biopsy. Look for enlarged parathyroid glands caused by disease. Normal parathyroid glands are often hard to see on ultrasound Thyroid ultrasound is not part of the routine evaluation of hypothyroidism unless the patient also has a large goiter or a lumpy thyroid. Incidentally discovered thyroid nodules are common. Overzealous use of ultrasound will frequently identify nodules that are unrelated to the abnormal thyroid function

The ultrasound assesses the size of the thyroid, the pattern and structure of tissue, and the presence of nodules. Patients with elevated TPO antibodies but normal thyroid function tests (TSH and Free T4) do not necessarily require treatment. Similarly, patients with only slightly elevated TSH may not require medication, either Thyroid ultrasound is an established pillar in the diagnosis and management of palpable thyroid findings and thyroid cancer, but at least 2/3 of the world lacks access to ultrasound imaging [2][3. This chapter will explain normal neck anatomy, with specific attention to the thyroid and its surroundings. It is important to have a solid grasp of the normal ultrasound appearance of all of the neck structures, enabling you to readily identify abnormal findings, and normal variants The usual blood tests done for thyroid function are TSH, T4 and sometimes T3. In most cases, your TSH level will be the first hormone to be measured, because if this is normal, it is very likely that your thyroid is functioning normally. The exception to this is when a pituitary problem is suspected, in which case T4 should be measured as well

Standardization and development of novel techniques are key factors to improving thyroid ultrasound, and both should be considered in normal clinical use. Introduction In recent years, the high incidence of thyroid nodules has become particularly significant, primarily because of its gradually increasing annual prevalence and the increasing use. Welcome to Ultrasoundpaedi. a's new look! Our new website includes all the same, quality content, now wrapped in a faster, even friendlier format. With 100s of new still images, videos and links, we are sure you will find that the hard work has been worthwhile. To provide a one stop ultrasound site for medical professionals. We endeavour to. Likewise, is Hypervascular thyroid normal? On color Doppler, the thyroid can vary from slightly hypervascular to markedly hypervascular (Figure 1B). Although this is a focal thyroiditis within a sonographically normal thyroid, it is unusual and represents about 5% of thyroid nodules. Also Know, does heterogeneous thyroid mean cancer? Background Introduction. Chronic lymphocytic thyroiditis, or Hashimoto's thyroiditis (HT), is an autoimmune disease related to and mediated by anti-thyroid autoantibodies (1-4).It is a common disease that may affect up to 2% of all women in the population that commonly occurs between the ages of 30 and 50 years ().The diagnosis of HT is based on clinical findings and the results of biochemical and. Many doctors look just at the TSH (thyroid stimulating hormone) levels when they are assessing a patient for a potential thyroid problem. However, TSH levels only begin to expose potential issues. An individual may have normal TSH levels but still not be utilizing thyroid stimulating hormone correctly, leading to a thyroid imbalance

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Thyroid Siz

Thyroid Nodules American Thyroid Associatio

Thyroid blood tests are used to tell if your thyroid gland is functioning properly by measuring the amount of thyroid hormones in your blood. They are done by withdrawing blood from a vein in your arm. These blood tests help to diagnose thyroid diseases. The thyroid is a butterfly-shaped gland located in the front part of your neck Thyroid cysts - Thyroid cysts are a type of thyroid nodule but they are filled with fluid. These cysts are often identified very easily with thyroid ultrasound but can present the same way as a thyroid nodule. Hashimoto's thyroiditis - Hashimoto's thyroiditis is an autoimmune condition of the thyroid gland which also causes hypothyroidism. This. Thyroid Ultrasound Dictation. Technique: A sonogram of the thyroid gland was performed assessing gray-scale appearance and color doppler flow. The left lobe is normal in size measuring [x] x [x] x [x] cm. The right lobe is normal in size measuring [x] x [x] x [x] cm. No nodules are seen. The isthmus is normal in size measuring [x] in maximum AP. Thyroid nodules are lumps or growths of the thyroid, usually made up of normal thyroid tissue or fluid. Thyroid nodules are frequently discovered on routine physical examination or unintentionally on imaging tests. By the age 45, up to half of normal people have thyroid nodules that can be seen on an ultrasound Blood flow: Color on your thyroid ultrasound means that color doppler was applied and blood flow was detected. It is generally normal unless there is too much co Read More. Send thanks to the doctor. 90,000 U.S. doctors in 147 specialties are here to answer your questions or offer you advice, prescriptions, and more

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Nonfunctioning nodules and nodules in a patient with a normal or high thyroid- stimulating hormone level may require fine-needle aspiration based on ultrasound characteristics and size My thyroglobulin level was undetectable and my free t4 was 23 now, down from 31 when we reduced my synthroid dose. I don't get to have another blood test or another ultrasound for 6 months. He said that the Dr who read the ultrasound did not seem to see any changes in the lymph nodes and noted that they look normal The objective of this study was to determine the measurement of normal range of ultrasound (US) thyroid gland dimensions in school-aged children (6-16 years) in our environment and compared with.

Thyroid Evaluation in a Patient with Thyrotoxicosis with

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A developmental variant of the thyroid cartilage

Thyroid Ultrasound: Uses, Side Effects, Procedure, Result

At this stage, your thyroid is still close to fully functional. That means TSH blood tests won't be sensitive enough to reveal Hashimoto's. If you're tested positive for thyroid antibodies (TPO or TG), you should get a thyroid ultrasound or have a biopsy as your doctor might diagnose you with Hashimoto's at this point

Measurement of shear wave velocities coupled with an

Enlarged thyroid gland with normal thyroid function test

An ultrasound of the thyroid gland is also one of the first tests ordered to evaluate a thyroid nodule. Results of the ultrasound may show the nodule's location, size, shape and other characteristics and whether more than one nodule is present. Ultrasound may also be used to: Evaluate the remainder of the neck structures, including lymph nodes Normal Size Range. According to endocrinologist Dr. Mark Lupo, normal dimensions for the thyroid gland are 4 to 4.8 x 1.0 to 1.8 x 0.8 to1.6 cm. However, dimensions that fall outside of this range do not necessarily signify abnormal pathology A thyroid scan is a type of nuclear medicine imaging. The radioactive iodine uptake test (RAIU) is also known as a thyroid uptake. It is a measurement of thyroid function, but does not involve imaging. Nuclear medicine uses small amounts of radioactive material called radiotracers. Doctors use nuclear medicine to diagnose, evaluate, and treat. Thyroid-stimulating hormone — Thyroid-stimulating hormone (TSH) can be measured with a blood test. If the blood test shows that your TSH level is normal, the next step is to have a thyroid ultrasound. Depending upon the appearance of the nodule on ultrasound, a fine-needle aspiration (FNA) biopsy may be recommended Goiters and Thyroid Nodules. Any enlargement of the thyroid gland can be called a goiter. A thyroid nodule is a growth, or lump, in or on the thyroid gland. A patient with a goiter can be either hypothyroid, hyperthyroid, or can have totally normal thyroid function. The presence of a goiter does not indicate how the thyroid gland is functioning

Why Would A Thyroid Doctor Order An Ultrasound? Paloma

Overgrowth of normal thyroid tissue. An overgrowth of normal thyroid tissue is sometimes referred to as a thyroid adenoma. It's unclear why this occurs, but it's not cancerous and isn't considered serious unless it causes bothersome symptoms from its size. Some thyroid adenomas lead to hyperthyroidism. Thyroid cyst A blood test called a thyroid function test is used to check the levels of thyroid hormones in your blood. Abnormal levels could mean that you have an overactive thyroid or an underactive thyroid, rather than cancer. Further tests, such as an ultrasound scan, will be needed if the test shows that your thyroid hormone levels are normal We evaluated associations between thyroid hormone levels, body composition and insulin resistance in euthyroid subjects with normal thyroid ultrasound (US) findings. Design and Patients This retrospective cross‐sectional study included 36 655 euthyroid subjects who joined the medical health check‐up programme at our institution 4.1 Thyroid gland 4.2 Parathyroid glands 4.3 Salivary glands 4.4 Lymph nodes 4.5 Miscellaneous. Breast and Axilla. 5.1 Benign lesions 5.2 Malignant breast lesions 5.3 Pitfalls 5.4 Elastography 5.5 3D imaging 5.6 Axilla 5.7 Prosthesis 5.8 Male breast. Musculoskeletal Joints and Tendons Thyroid nodules are usually firm, smooth, and easily felt through the skin if they are large enough . Most nodules over 2 cm are palpable during a careful examination of the neck area. Smaller nodules are usually only detectable by ultrasound. The rest of the gland feels normal

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Thyroid Ultrasound: Purpose, Procedure & Benefit

Thyroid cancer has a good prognosis, a high survival rate, and a low recurrence rate, so early diagnosis and treatment are crucial. Recently, a joint research team in Korea has proposed a new non-invasive method to distinguish thyroid nodules from cancer by combining photoacoustic (PA) and ultrasound image technology with artificial intelligence Ultrasound of the thyroid gland. The green arrow points to the breathing tube (trachea). The yellow arrow points to a nodule in the right side of the thyroid gland (the ultrasound pictures are a mirror image: meaning left side of image is on the patient's right side and vice versa) which is a FNA biopsy proven diagnosis of papillary thyroid. Thyroid follicles are destroyed and replaced by small lymphocytes so that the echogenicity of the thyroid parenchyma markedly decreases, becoming similar to that of the surrounding strap muscles. Thyroid ultrasound can also inform and quantify the volume of the thyroid gland . The field of thyroid ultrasound is expanding rapidly