Carl C. Reading MD, Presenter: Nothing to Disclose

1) Recognize the sonographic appearance of recurrent and metastatic disease, and other abnormalities, in the post-operative neck.

In the post-thyroidectomy neck, ultrasound surveillance is a highly effective method to evaluate for residual and recurrent disease. Recurrence can occur anywhere within the neck, but typically is located in the mid and low internal jugular chains and thyroid bed region. Abnormal cervical lymph nodes can be recognized with a high degree of accuracy due to abnormal size, shape, internal architecture, and color Doppler appearance. In patients with suspected metastatic papillary cancer, the presence of internal fluid or calcifications is highly predictive of malignancy. Abnormal nodal color Doppler flow including peripheral (non-hilar), increased, and irregular flow is highly predictive of malignancy. Within the post-operative thyroid bed, itself, residual thyroid tissue, tumor recurrence, and suture granulomas can occur. FNA for cytologic analysis of suspected abnormalities can be performed, and the addition of thyroglobulin and calcitonin assay of the specimen, for papillary and medullary cancer, respectively, adds a high degree of accuracy to this procedure.

Reading, C, Post-Thyroidectomy Neck.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14000585.html