Ultrasound can accurately diagnose colloidal cysts

The article is professionally consulted by Master, Doctor Nguyen Hong Hai - Radiologist - Department of Diagnostic Imaging and Nuclear Medicine - Vinmec Times City International Hospital

Sometimes normal thyroid tissue begins to grow, causing one or more thyroid cysts. In particular, colloidal thyroid cyst is a common benign disease caused by iodine deficiency. Colloidal cystic disease usually has no specific symptoms and diagnosis is mainly based on ultrasonography.

Colloid goiter is a common benign lesion of the thyroid gland, diffuse or nodular. The important feature of colloidal thyroid cysts is the colloid contained within and the cometary tail sign shown on ultrasound. However, some cases of colloidal thyroid cysts do not show cometary tail signs and sometimes these signs need to be differentiated from microcalcifications in malignant lesions.
Colloid goiter is defined as an enlarged thyroid gland without thyroid dysfunction. This is a common pathology, often seen in clinical practice during physical examination or ultrasound. Colloidal thyroid cysts are classified as benign thyroid cysts according to the TIRADS classification. Colloidal cystic disease is also known as simple thyroid cyst, benign thyroid cyst, nontoxic multinodular goiter, or nodular hyperplasia. They are benign lesions; however, on sonographic images, they may need to be distinguished from malignancies.
There are many mechanisms and causes of colloidal cystic disease. Several factors can lead to colloidal cysts including foods that inhibit hormone synthesis, mutations in the thyroid-stimulating hormone (TSH) receptor, thyroid-stimulating globulin, growth hormone, and weakness. insulin-like growth factor 1 (IGF-1) and genetic factors. Dietary iodine deficiency is also known to lead to colloid nodules. There is evidence that iodine supplementation may reduce the incidence of cystic thyroid disease in these individuals; However, some cases of chronic colloidal cystic disease do not always go away with iodine supplementation.
It is also thought that factors that control thyroid function, such as C cells, can alter iodine levels, leading to follicular disease. According to several studies, iodine deficiency is associated with a 5–10% prevalence of cystic thyroid disease. The peak age for follicular onset is 35–50 years, and the ratio of women to men affected by cystic disease is 3: 1. There is no correlation between race and incidence of cystic disease.

Diagnosis and treatment of colloid goiter is still controversial. The most important aspect of goiter is its differential diagnosis from malignancies of the thyroid gland (thyroid cancer).
Most patients with colloidal thyroid nodules have no significant signs or symptoms. The patient's owner was discovered by family members or by chance during routine health check-ups. Many cases of thyroid cancer have the characteristics of a benign nodule, especially when the lesion is small in size.
Need to find out some information about history related to head and neck irradiation, family history of thyroid cancer, Cowden's disease, Gardner's syndrome... For patients with goiter acacia (benign) tumor did not rapidly increase in size, did not affect swallowing and voice, and did not present with symptoms of hyperthyroidism or hypothyroidism. Signs of compression usually appear in large cysts.
Physical examination reveals a tender, mobile, and painless thyroid. However, clinical results are often inaccurate because they depend heavily on the skill and location of the goiter. Small thyroid nodules are usually not clinically palpable unless located anteriorly. Therefore, there is a need for imaging techniques, in which ultrasound has many values ​​in the diagnosis of colloid goiter.

High resolution ultrasonography is valuable for accurate detection of thyroid nodules that are not clinically palpable. Further determination of the number of thyroid nodules (mononuclear or multinodular), measurement of thyroid nodule size and goiter volume. Ultrasound is also of great value in differentiating simple thyroid cysts (with low cancer risk) and solid, mixed nodules (with high cancer risk).
Besides, ultrasound also has the effect of supporting diagnosis (such as guiding aspiration of goiter cells) as well as treatment of aspiration, alcohol injection or laser treatment).
Ultrasound is valuable in excluding malignancies such as hypoechoic thyroid nodules, microcalcifications, thyroid nodules with irregular margins, intranuclear vascular proliferation and tumor invasion, and regional lymph node examination. neck.
Some changes in the sonographic image of goiter due to degeneration include an acoustic void (due to serous or colloidal fluid), echogenic structure in the fluid, or fluid-fluid levels (due to hemorrhage). ). Or bright spots with faint trailing may be seen on the tail due to the density of the colloids (the comet's tail sign). Internally, fatigued septa can be seen, on the doppler there is vascular signal in the septum (may be confused with cystic thyroid cancer, but this is a rare condition).
In summary, thyroid ultrasonography is of key value in the evaluation and diagnosis of colloidal cysts. Ultrasound can identify suspected thyroid nodules (excluding some thyroid cancers) and detect clinically undetectable small thyroid nodules.

Patients need to go to a reputable hospital to conduct examination and treatment as soon as there are signs of colloidal thyroid cyst disease. Currently, Vinmec International General Hospital is one of the leading prestigious hospitals in the country, trusted by a large number of patients for medical examination and treatment. Not only the physical system, modern equipment: 6 ultrasound rooms, 4 DR X-ray rooms (1 full-axis machine, 1 light machine, 1 general machine and 1 mammography machine) , 2 DR mobile X-ray machines, 3 multi-row computer tomography rooms with receivers (1 128-series, 1 512-series and 1 640-series), 4 Magnetic Resonance imaging rooms (3 3 Tesla and 1 1.5 Tesla machine), 1 room for interventional angiography with 2 aspects and 1 room for measuring bone mineral density.... Vinmec is also the place to gather a team of experienced doctors and nurses who will assist a lot in the treatment. Diagnosis and early detection of abnormal signs of the patient's body. In particular, with a space designed according to 5-star hotel standards, Vinmec ensures to bring the patient the most comfort, friendliness and peace of mind.