The Relevance of Thyroid Nodules in Vascular Ultrasound: A Case-Based Literature Review

Abstract

Thyroid nodules are found by ultrasound in up to 67% of the population, of which 1% to 15% are malignant. As the thyroid may be imaged during a carotid study, vascular technologists should be aware of normal and abnormal thyroid appearances. Interpreting physicians need this information to report on incidentally found thyroid nodules. Such reports could lead to further referral, detailed thyroid ultrasound, or other diagnostic modalities guiding further management.

A literature review was conducted regarding thyroid findings on ultrasound. Illustrative images were collated to demonstrate thyroid findings that may be encountered by vascular technologists during carotid duplex studies.

Vascular technologists are not usually trained in thyroid scanning. Thyroid findings on a carotid duplex are “incidental” but may identify important pathology. Thyroid nodule characterization such as size, shape, contour, consistency, echogenicity, texture, blood flow pattern, and calcification may be needed by interpreting physicians in combination with additional images. Definitive assessment requires a dedicated thyroid study with application of the TI-RADS (Thyroid Imaging Reporting & Data System^TM) classification. Identifying thyroid pathology on a carotid ultrasound study can reveal important information and lead to further investigation. Early identification of such pathology by a vascular technologist can be lifesaving. Characteristics of thyroid lesions can be readily demonstrated by the vascular technologist, assessed by the interpreting physician, and reported to the referring provider for definitive work-up and treatment.