Thyroid Ultrasound and Ultrasound-Guided FNA: Second Edition by Robert A. Levine M.D.,MACE (auth.), H. Jack Baskin

By Robert A. Levine M.D.,MACE (auth.), H. Jack Baskin M.D.,MACE, Daniel S. Duick M.D.,MACE, Robert A. Levine M.D.,MACE (eds.)

Thyroid Ultrasound and Ultrasound-Guided FNA, moment Edition is a "user pleasant" booklet for the clinician, utilizing ultrasound within the assessment and administration of thyroid sickness. It studies new information about ultrasound and the subtleties one must understand within the software of this method.

With plentiful ultrasound pictures, it demonstrates how ultrasound is built-in with the sufferer heritage, actual examination, and different thyroid exams (especially FNA biopsy) delivering details on enhancing care.

The booklet offers quite a few, new cutting edge makes use of of ultrasound which are being applied worldwide.

Foreword by means of Leonard Wartofsky, MD, MACP, Chairman, division of medication, Washington health center heart, Washington, DC.

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Extra resources for Thyroid Ultrasound and Ultrasound-Guided FNA: Second Edition

Example text

As Graves’ disease typically has very intense flow, the absence of flow in a thyrotoxic patient would be suggestive of thyroiditis. A. LEVINE FIG. 14. Subacute thyroiditis. Subacute thyroiditis may also be associated with any degree of vascular flow. This image shows decreased flow associated with subacute thyroiditis reflect either Graves’ disease or thyroiditis in a thyrotoxic patient. Doppler imaging may be useful in cases of thyrotoxicosis factitia in which minimal intrathyroidal vascular flow is observed.

Typically, type 2 amiodarone thyrotoxicosis is associated with absent or a very low degree of vascularity on power Doppler analysis (8). Bogazzi demonstrated a 58% response to steroid therapy when flow was absent on color Doppler imaging, and only a 14% steroid response rate when flow was present (9). A suggested treatment algorithm, using power Doppler analysis, suggests the use of steroid therapy when no flow is present. If flow is present, and especially if extremely vascular, thionomides with or without perchlorate are recommended.

The specificity was 85%, and the diagnostic accuracy was 81%. The prevalence of cancer in this group of follicular nodules was 14%. In a similar analysis, De Nicola (6) studied 86 patients in whom nodules had prior follicular biopsies. The flow pattern was characterized on a scale from 0 to 4, with 0 defined as no visible flow, 1 as peripheral flow only, 2 as peripheral flow with a small amount of central flow, 3 as peripheral flow plus extensive intranodular flow and 4 as central flow only. Patterns 0–2 were grouped as negative results, and nodules with pattern 3–4 were considered positive.

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