Can you interpret my ultrasound results that were taken after my MRI scan revealing a 0.23-inch thyroid nodule?

Question

Hello doctor,

I had an MRI (magnetic resonance imaging) done and they found a 0.23 inches nodule on my thyroid. They decided to get a baseline ultrasound and the results follow. Here is the ultrasound report:

Findings:

The right lobe measures 45 x 21 x 15 mm. The left lobe measures 46 x 18 x 14 mm.
RIGHT lobe: The right lobe has homogeneous echotexture. There is a 1.4 x 0.9 x 0.6 cm isoechoic solid nodule. There are no calcifications.
LEFT lobe: The left lobe of the thyroid has a homogeneous echotexture. There are no significant nodules in the left lobe of the thyroid. The thyroid isthmus is unremarkable.
Impression: Right thyroid nodule. 12-month follow-up thyroid ultrasound is recommended.

My guess is they gave it a score of 3. My question is, if it had been 0.59 inches instead of 0.55 inches would it require a biopsy? What are your thoughts for a follow-up?

*Also, I had a chest CT scan done two years earlier. It showed the lower neck with no findings. Does this mean the nodule has grown quickly since the last one or are CT scans of the chest less sensitive than direct ultrasounds of the nodule?

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

CT (computed tomography) scan has better resolution, but CT scan is more sensitive, I suggest FNAC (Fine needle aspiration cytology) of thyroid nodule should be done to confirm the diagnosis If fnac is normal. Then repeat ct scan which ultimately should be done after three months to see any comparison. If there is growth in the neck side. Then ultrasound neck should be done early. Should not wait for three months.

Thanks and regards.

Answer 2

Hi,

Welcome back to iclinioq.com.

MRI(magnetic resonance imaging) is a more confirmatory and accurate diagnosis, will rely on MRI findings, will ignore ultrasound findings, ultrasound findings are not so accurate, ultrasound readings could be false, MRI suggests 0.23 inches nodule,

I will rely on this, the size is too small, biopsy cannot be done. Can try for FNAC (fine needle aspiration cytology), If FNAC is also not possible. Then it needs observations, which should repeat MRI after three months, In such cases, should repeat ultrasound after one month to see if any changes in the current findings, although they are not so reliable, still it is a basic test If there is any increase in size on ultrasound, then early MRI should be done.

Hope I have clarified your doubts.

Thanks and regards.