Imaging
Toxic Nodular Goiter
- Preliminary Diagnosis: Toxic Nodular Goiter
-
I. What imaging technique is first-line for this diagnosis?
- II. Describe the advantages and disadvantages of this technique for diagnosing toxic nodular goiter.
-
III. What are the contraindications for the first-line imaging technique?
-
IV. What alternative imaging techniques are available?
- V. Describe the advantages and disadvantages of the alternative techniques for diagnosing toxic nodular goiter.
- VI. What are the contraindications for the alternative imaging techniques?
Preliminary Diagnosis: Toxic Nodular Goiter
I. What imaging technique is first-line for this diagnosis?
Ultrasound of the thyroid gland.
II. Describe the advantages and disadvantages of this technique for diagnosing toxic nodular goiter.
Advantages
Highly portable imaging modality.
Does not expose patients to ionizing radiation.
May help guide percutaneous biopsy and FNA.
Able to evaluate the vascularity of any suspicious lesions of the thyroid gland.
Disadvantages
Limited in evaluating and characterizing any surrounding soft tissue.
III. What are the contraindications for the first-line imaging technique?
No specific contraindications to ultrasound exist.
IV. What alternative imaging techniques are available?
Nuclear medicine thyroid imaging.
CT imaging with IV contrast.
V. Describe the advantages and disadvantages of the alternative techniques for diagnosing toxic nodular goiter.
Nuclear medicine thyroid imaging
Advantages
Able to detail hot and cold nodules with great specificity.
Moderately sensitive in detecting thyroid abnormalities.
Disadvantages
Less adept in guiding percutaneous intervention.
Limited in detailing and evaluating the surrounding soft tissues, osseous structures, and vasculature.
May be subject to image artifact.
CT imaging with IV contrast
Advantages
Moderately sensitive and specific in detailing and detecting toxic nodular goiter.
May help guide treatment, therapy, and biopsy.
Highly sensitive and specific in detecting abnormal mineralized thyroid abnormalities.
Offers exquisite visualization and detail of the surrounding soft tissues, osseous structures, and vasculature.
Disadvantages
Exposes patients to ionizing radiation.
Limited in detailing the vascularity of specific thyroid lesions.
VI. What are the contraindications for the alternative imaging techniques?
Nuclear medicine thyroid imaging
May be contraindicated in pregnant patients and those who are breast feeding.
CT imaging with IV contrast
May be contraindicated in pregnant patients.
May be contraindicated in patients with renal failure and contrast allergy.
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