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What Does The Thyroid Ultrasound Reports Indicate?

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Posted on Sat, 18 Oct 2014
Question: Thyroid ultrasound shows 1.3cm nodule and nuclear thyroid scan shows no definitive nodularity present.. Why does nodule show up on one and not the other??
doctor
Answered by Dr. Binu Parameswaran Pillai (40 minutes later)
Brief Answer:
Cold nodules

Detailed Answer:
Good day.
Welcome to health care magic and thank you for asking the question. I noted that ultrasound picked up a nodule where as nuclear scan didn't. This is called as a cold nodule. Nuclear scan is a functional scan. For a nodule to light up in nuclear scan, it must take up the nuclear XXXXXXX and retain with in the nodule. Some nodules are degenerated and lack piwer to take up or retain the XXXXXXX That is tbe reason why they don't show up in the scan later and are called as cold nodules.
The next step would be a needle test of the noduke to rule out malignancy. There is a small risk of malignancy in cold nodules.
Regards
Binu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Binu Parameswaran Pillai (13 hours later)
Thyroid scan showed cold nodules on left side of thyroid but on the right side where ultrasound showed 1.3cm nodule thyroid scan show no nodules cold or hot on right side?
doctor
Answered by Dr. Binu Parameswaran Pillai (11 hours later)
Brief Answer:
Different properties of thyroid nodule

Detailed Answer:
Good day,
Apologies for the delay in reply.

As i mentioned earlier, ultrasound and nuclear scan are 2 different types of scans and that is exactly the reason why doctors use the combination of these.

Ultrasound is anyday better for anatomical details ( structural details) of the thyroid. Where as nuclear scan is based on the functional quality of the thyroid and nodules.

One other thing is that, TSH values at the time of doing scan plays a great role in nuclear scan. If the initial TSH is low , the gland /nodule is hyperfunctioning and there is a better chance of nuclear XXXXXXX to be picked up.

If the TSH was normal or slightly high, nuclear scan is not really helpful. ( in some countries general physicians use nuclear scans routinely. Where as, endocrinologists use it more sparingly, based on the TSH values). In my practice , i do not use nuclear scan routinely, if the initial TSH is not low. That is the universal recommendations as well.

Some nodules lack the function of uptake or retention of XXXXXXX They either dont take up the radio idoine. Even if they take up, they do not retain the XXXXXXX BAsed on this the nodule is either not visible or appear as cold nodule in a nuclear scan.

But since ultrasound directly view the structure of the gland, it will pick up any nodule irrespective of its functional status.


I would like to know how was your initial TSH value. Please cut and copy any of the following links to your browser to view the work up of thyroid nodules.

https://www.google.com/search?q=thyroid+nodule+work+up+algorithm&biw=1242&bih=585&source=lnms&tbm=isch&sa=X&ei=-OckVOCYMe207QbZpoHYCA&ved=0CAYQ_AUoAQ#facrc=_&imgdii=_&imgrc=QxoKVb5kvEZKbM%253A%3B4ub68c4JXT6KIM%3Bhttp%253A%252F%252Fwww.nucmed.com%252FNucMed%252Falgorithms%252FThyroid_Nodules%252Ffig-1.jpg%3Bhttp%253A%252F%252Fwww.nucmed.com%252FNucMed%252Falgorithms%252FThyroid_Nodules.htm%3B1708%3B2217


https://www.google.com/search?q=thyroid+nodule+work+up+algorithm&biw=1242&bih=585&source=lnms&tbm=isch&sa=X&ei=-OckVOCYMe207QbZpoHYCA&ved=0CAYQ_AUoAQ#facrc=_&imgdii=_&imgrc=M3fHCPI9S_tMuM%253A%3BlXCTHHU_UDQiZM%3Bhttp%253A%252F%252Fwww.pineviewsurgery.org%252Fata_nodule_work_up.jpg%3Bhttp%253A%252F%252Fwww.pineviewsurgery.org%252FPhysicians-Page.html%3B784%3B344
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Binu Parameswaran Pillai

Endocrinologist

Practicing since :2003

Answered : 1439 Questions

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What Does The Thyroid Ultrasound Reports Indicate?

Brief Answer: Cold nodules Detailed Answer: Good day. Welcome to health care magic and thank you for asking the question. I noted that ultrasound picked up a nodule where as nuclear scan didn't. This is called as a cold nodule. Nuclear scan is a functional scan. For a nodule to light up in nuclear scan, it must take up the nuclear XXXXXXX and retain with in the nodule. Some nodules are degenerated and lack piwer to take up or retain the XXXXXXX That is tbe reason why they don't show up in the scan later and are called as cold nodules. The next step would be a needle test of the noduke to rule out malignancy. There is a small risk of malignancy in cold nodules. Regards Binu