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High Resolution Neck Ultrasound and Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid

High resolution neck ultrasound has revolutionized the diagnosis and treatment of thyroid and parathyroid nodular disease. In the late 1980s, several endocrinologists across the country began to use neck ultrasound for the evaluation and biopsy of small thyroid lumps that could not be felt by hand. Since then, ultrasound resolution capabilities have improved so much that parathyroid tumors underneath the thyroid and deep in the neck can actually be seen.

In addition, clinical endocrinologists have access to comprehensive knowledge of the patient's historical data, physical examination details and other laboratory testing information that significantly increase the physician's ability to locate thyroid and parathyroid nodules. This has led to the recruitment of a new generation of endocrinologist ultrasonographers who are using neck ultrasound in inventive ways to diagnose and treat thyroid and parathyroid disease. R. Mack Harrell, MD, is one of these pioneers.

Neck Ultrasound Experience

Dr. Harrell has personally performed thousands of neck ultrasounds since 1991. In 2006 alone, he personally conducted more than 700 ultrasound evaluations of neck endocrine structures. Dr. Harrell believes that the doctor making the clinical decisions should be the person who searches the neck for disease.

Using a General Electric e-9 ultrasound with matrix probe technology, Dr. Harrell can identify enlarged parathyroid glands in 90 percent of his parathyroid patients with calcium levels higher than 11.0 mg/dl. With accurate ultrasound localization of parathyroid tumors, there is a greater-than 95 percent chance that minimally invasive surgery will be successful.

Read an article on the importance of collaboration between an ultrasonographer and endocrine surgeon to perform minimally invasive radio-guided parathyroid surgerypdf, written by R. Mack Harrell, MD, and David N. Bimston, MD.

Diagnostic Efficiency

In addition, Dr. Harrell uses his office ultrasound probe to guide him in performing fine needle aspiration biopsy of thyroid nodules to help rule out thyroid cancer. With ultrasound guidance, biopsies can be obtained in less than 10 minutes without any need for injected anesthesia agents (just a little skin numbing with an ice-cold skin spray of ethyl chloride). The same procedure in a hospital radiology setting typically involves several shots of injected xylocaine for local anaesthesia and 60 minutes of special procedure time. When it comes to maximizing diagnostic efficiency in thyroid and parathyroid disease, there may be no better option than high resolution, office-based ultrasound in the hands of a certified clinical endocrinologist.



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