1) hypoechoic thyroid gland 2) coarse echotexture of the gland 3) fine linear echoes within the thyroid parenchyma s/o fibrosis 4) Color doppler imaging reveals augmentation of the vascularity of the thyroid gland. These ultrasound images are diagnostic of Hashimoto's thyroiditis.

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thyroiditis:enlarged thyroid gland(arrows) with diffusely coarsed hypo echoic echotcture
that is typical of Hashimoto's thyroiditis.

scanty blood flow seen in this normal thyroid scan.

marked hyper vascularity of the left thyroid parenchyma in case of grave's disease.

On ultrasound examination, the enlarged and asymmetric gland usually contains multiple solid nodules 1 to 4 cm large. Coarse calcifications may be present, as may areas of hemorrhage or necrosis. A solitary nodule found on clinical or scintigraphic examination has been considered more likely to be neoplastic than multiple nodules.5 On pathologic examination, however, half of clinically identified single nodules have proved to be dominant nodules of multinodular goiters.22 In another study,23 33% of patients undergoing surgical treatment for papillary cancer had coexistent benign nodules found intraoperatively. Therefore, multinodularity does not mean benign disease. Every nodule must be examined for its own ultrasonographic characteristics. As with the physical examination, if ultrasonography can identify a single dominant or more malignant-appearing nodule in a multinodular gland, FNA is directed to the more suspicious-looking nodule. A palpable or dominant nodule should particularly be suspect.

two hypo echoic nodules in the right and left thyroid lobes,the one seen in the right lobe showed punctate psammomatous calcification(small arrows).

benign adenoma showed large amount of blood flow.
spectral doppler showed low peak systolic velocity and prominent diastolic flow.

papillary carcinoma showed moderate amount of blood flow.

spectral doppler showed higher peak systolic velocity with relatively less diastolic flow than within benign nodule.

thyroid nodule with calcified rim(the presence of internal coarse or peripheral eggshell-type calcifications suggest benign lesion ).

1cm hyper echogenic nodule


Other benign features include hyperechogenicity relative to the adjacent parenchyma

Benign cystic nodule with dependent debris.

Typical benign nodules are well-marginated, mostly cystic masses that almost always contain internal debris

In multiloculated benign cystic lesions, internal septa may be thickened but should be devoid of vascular flow.