Imaging Modalities for Endocrine System
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Questions and Answers

What is the initial effect of inflammation on thyroid hormones in Hashitoxicosis?

  • Transitory elevation of thyroid hormones (correct)
  • Transitory decrease in thyroid hormones
  • Persistent elevation of thyroid hormones
  • No effect on thyroid hormones

    • Which imaging modality is superior to CT for assessing invasion of trachea/oesophagus in thyroid cancer?

  • Ultrasonography
  • PET-CT
  • MRI (correct)
  • Scintigraphy

    • What is the characteristic appearance of enlarged parathyroid glands on imaging?

  • Anechoic nodules
  • Isoechoic nodules
  • Hyperechoic nodules
  • Hypoechoic nodules (correct)

    • What is the primary purpose of contrast-enhanced CT scans in thyroid cancer?

    <p>To assess the extension and invasion of tumor into adjacent neck structures</p> Signup and view all the answers

    What is the role of Ultrasonography Guided Fine Needle Aspiration (FNA) in thyroid nodules?

    <p>To collect a tissue sample for cytological analysis</p> Signup and view all the answers

    Which of the following is NOT a type of thyroid nodule?

    <p>Parathyroid nodule</p> Signup and view all the answers

    What is the role of Scintigraphy in thyroid imaging?

    <p>To assess the function of thyroid nodules</p> Signup and view all the answers

    Which imaging modality is NOT commonly used in thyroid gland imaging?

    <p>X-ray</p> Signup and view all the answers

    What is the recommended imaging modality for the thyroid gland?

    <p>Ultrasound</p> Signup and view all the answers

    What is the characteristic of a Lipid-Poor Adenoma on CT?

    <p>Signal drop on out-of-phase imaging</p> Signup and view all the answers

    What is the role of fat in differentiating Adenoma from Carcinoma?

    <p>Fat is identified in Adenoma to differentiate from Carcinoma</p> Signup and view all the answers

    What is the recommended imaging modality for the pituitary gland?

    <p>MRI</p> Signup and view all the answers

    What is the characteristic of a Parathyroid gland on imaging?

    <p>Not identifiable in all imaging modalities</p> Signup and view all the answers

    What is the characteristic of Graves' disease on Ultrasound?

    <p>Heterogenous, hypermetabolic</p> Signup and view all the answers

    What is the characteristic of a Pheochromocytoma on MRI?

    <p>High signal on T2W</p> Signup and view all the answers

    What is the role of Calcification in Adrenal Gland Pathology?

    <p>Coarse calcification is benign</p> Signup and view all the answers

    What is the recommended imaging modality for the adrenal gland in neonates and children?

    <p>Ultrasound</p> Signup and view all the answers

    What is the characteristic of an Adrenal gland on Ultrasound?

    <p>Layers of cortex and medulla are identifiable in neonates and young children</p> Signup and view all the answers

    What is the typical echogenicity of the thyroid gland in relation to the surrounding strap muscles on ultrasound?

    <p>Hyperechoic</p> Signup and view all the answers

    What is the normal range of length for the thyroid gland lobes on ultrasound?

    <p>4-5 cm</p> Signup and view all the answers

    What type of Doppler image is typically used to evaluate thyroid vascularity?

    <p>Color Doppler</p> Signup and view all the answers

    Which of the following imaging modalities uses ionizing radiation?

    <p>X-ray and Computed Tomography (CT)</p> Signup and view all the answers

    What is the typical appearance of the thyroid gland on ultrasound in the sagittal plane?

    <p>Oval shape</p> Signup and view all the answers

    What is the relationship between the thyroid gland and the parathyroid glands in terms of anatomical location?

    <p>The parathyroid glands are adjacent to the thyroid gland</p> Signup and view all the answers

    Study Notes

    Imaging Modalities for Endocrine System

    • Imaging modalities for the endocrine system can be categorized into ionizing radiation (X-ray, CT, fluoroscopy, angiography, nuclear medicine) and non-ionizing radiation (US, MRI) methods.

    Thyroid and Parathyroids

    • The thyroid gland is located in the anterior neck and has a schematic relationship with important anatomical landmarks.
    • The parathyroid glands are represented by green dots and are also located in the anterior neck.

    Thyroid US Anatomy

    • The thyroid gland appears homogenous and echogenic/hyperechoic on US, with a sagittal and axial plane.
    • The gland has a normal vascularity on color Doppler image, with a spectral Doppler flow showing a low resistive wave.
    • The transverse dimension (width-W) and anterior-posterior length (L) of the lobes are 4-5 cm.

    Thyroid Pathology

    • Thyroid pathology can be seen in adenoma, myelolipoma, trauma, and granulomatous infection.
    • Graves' disease appears as an enlarged, heterogenous, and hypermetabolic gland on imaging.
    • Hashimoto's disease cannot be differentiated from Graves' disease on imaging in its initial stage.

    Adrenal Gland

    • The adrenal gland can be imaged using CT, MRI, and PET-CT.
    • A lipid-poor adenoma appears as an indeterminate lesion on non-contrast CT, with a signal drop on out-of-phase imaging compared to in-phase imaging.
    • Pheochromocytoma appears as a heterogeneous enhancing right adrenal mass on CT, with intense tracer uptake on PET-CT and a high signal on T2W MRI.
    • Adrenocortical carcinoma appears as a heterogeneous enhancing right adrenal mass on CT, with punctate, irregular calcifications.

    Take Home Messages

    • The first line of imaging modality for endocrine system components depends on the type of organ being imaged.
    • Complimentary imaging modalities are used to further evaluate the organ.
    • Thyroid gland appears homogenous and echogenic/hyperechoic on US, and hyperdense on CT.
    • Parathyroid gland is not identifiable in all imaging modalities when normal, but appears as a hypoechoic nodule when enlarged.
    • Pituitary gland is best evaluated using MRI, which can identify microadenoma and macroadenoma.
    • Adrenal gland is best evaluated using US in neonates and children, and CT in adults.

    Thyroid Nuclear Medicine Studies

    • Scintigraphy and PET-CT are used to evaluate thyroid nodules and carcinoma.
    • Malignant nodule carcinoma appears as a hot spot on isotope scan/scintigraphy and PET-CT.

    Parathyroid Gland Pathologies

    • Parathyroid gland pathologies can be seen in adenoma and hyperparathyroidism.
    • Enlarged parathyroid glands appear as hypoechoic nodules on US and may compress the adjacent anterior thyroid parenchyma.

    FNA and Ultrasound

    • Ultrasonography-guided fine needle aspiration (FNA) is used to diagnose thyroid nodules.
    • Contrast-enhanced CT scans and MRI are useful in evaluating the extension and invasion of tumor into the adjacent neck structures.

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    Related Documents

    Radiology of Endocrine System PDF

    Description

    This quiz covers the different imaging modalities used to diagnose and visualize the endocrine system, including the thyroid and parathyroid glands.

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