Echocardiography: How It Is Done and How the Report Is Built
The longest report in the department: about fifty values, calculated formulas and an impression, built by voice during the scan.
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Thyroid
How a thyroid ultrasound is done
The thyroid is superficial and quick to scan, but its report is detailed: three dimensions per lobe, a volume formula, the isthmus, echotexture, every nodule described separately, and the cervical lymph nodes. Typing such a report by hand often takes longer than the exam itself.
What is examined
The patient lies supine with a pillow under the shoulders and the neck extended. A linear probe at 7-12 MHz is used. Start with a transverse view through the isthmus, then take longitudinal views of each lobe.
Each lobe is measured in three dimensions: length, width and anteroposterior thickness. Lobe volume is calculated with the ellipsoid formula: the product of the three dimensions multiplied by a coefficient. Total gland volume is the sum of both lobes; the isthmus is not included if it is no thicker than five millimeters.
Next come contours, echogenicity and echotexture, nodules and calcifications, vascularity on color Doppler and the regional lymph nodes. Each nodule is described separately: size in three planes, composition, margins, vascularity and any echogenic foci, so a TI-RADS category can be assigned.
- Right and left lobe: length, width, thickness
- Volume of each lobe and total gland volume
- Isthmus thickness
- Contours, echogenicity, echotexture
- Nodules: size, composition, margins, vascularity
- Vascularity on color Doppler
- Regional lymph nodes
How long it takes
7-10minutes of scanning
+10minutes of typing
0minutes of typing by voice
The scan takes seven to ten minutes. Typing the report yourself adds about ten more: three dimensions per lobe, two volume calculations, nodule descriptions. Calculating volume by hand takes another minute and produces the most annoying typos, when a decimal point slips and the value is off by a factor of ten.
The same study by voice
By voice it looks like this: the physician states the dimensions, the volume is calculated with the same ellipsoid formula, and the echotexture and nodule descriptions go into their own fields. Play the whole dictation or click the lines one by one.
0:00 / 0:00
Tap a line to jump to that point of the recording.
- lobe volume is calculated automatically
This browser has no speech voice available. The buttons still work: the value drops into the report row.
THYROID ULTRASOUND0
| Parameter | Value | Reference |
|---|---|---|
| Right lobe | ||
| Right lobe length | ||
| Right lobe width | ||
| Right lobe thickness | ||
| Right lobe volume | ||
| Left lobe | ||
| Left lobe length | ||
| Left lobe width | ||
| Left lobe thickness | ||
| Left lobe volume | ||
| Isthmus | ||
| Isthmus thickness | ≤ 5 | |
| Total volume | ||
| Total thyroid volume | ≤ 18 (women), ≤ 25 (men) | |
| Gland structure | ||
| Contours | ||
| Echogenicity | ||
| Echotexture | ||
| Nodules | ||
| Vascularity (CDI) | ||
| Regional lymph nodes | ||
| Regional lymph nodes | ||
Lobe volumes and total volume are calculated with the same formula the physician would use, and the result is shown next to the reference value for the patient's sex. When a nodule is dictated, it gets its own row in the report with size and description, not a paragraph lost in the text.
Adult orientation values: total volume up to 18 ml in women and up to 25 ml in men, isthmus up to 5 mm. Norms differ in adolescents and during pregnancy. Interpretation always belongs to the physician.
What the finished document looks like
The document is built in two formats at once. The table is convenient for follow-up: six months later it is easy to see whether a nodule has grown. The narrative version is used when the report goes to an endocrinologist with a referral.
THYROID ULTRASOUNDdocument sample
Right lobe
| Right lobe length | 46 mm | |
| Right lobe width | 17 mm | |
| Right lobe thickness | 15 mm | |
| Right lobe volume | 5.6 ml |
Left lobe
| Left lobe length | 45 mm | |
| Left lobe width | 16 mm | |
| Left lobe thickness | 15 mm | |
| Left lobe volume | 5.2 ml |
Isthmus
| Isthmus thickness | 3 mm | ≤ 5 |
Total volume
| Total thyroid volume | 10.8 ml | ≤ 18 (women), ≤ 25 (men) |
Gland structure
| Contours | smooth, well defined | |
| Echogenicity | normal | |
| Echotexture | homogeneous | |
| Nodules | none | |
| Vascularity (CDI) | not increased |
Regional lymph nodes
| Regional lymph nodes | not enlarged |
Impression
No sonographic evidence of thyroid pathology. Gland volume within normal limits for age.
THYROID ULTRASOUNDdocument sample
Right lobe. Right lobe length 46 mm; Right lobe width 17 mm; Right lobe thickness 15 mm; Right lobe volume 5.6 ml.
Left lobe. Left lobe length 45 mm; Left lobe width 16 mm; Left lobe thickness 15 mm; Left lobe volume 5.2 ml.
Isthmus. Isthmus thickness 3 mm.
Total volume. Total thyroid volume 10.8 ml.
Gland structure. Contours smooth, well defined; Echogenicity normal; Echotexture homogeneous; Nodules none; Vascularity (CDI) not increased.
Regional lymph nodes. Regional lymph nodes not enlarged.
Impression
No sonographic evidence of thyroid pathology. Gland volume within normal limits for age.
THYROID ULTRASOUNDPDF
The PDF is built from the same report and is ready to print or send to the patient.
Right lobe
| Right lobe length | 46 mm | |
| Right lobe width | 17 mm | |
| Right lobe thickness | 15 mm | |
| Right lobe volume | 5.6 ml |
Left lobe
| Left lobe length | 45 mm | |
| Left lobe width | 16 mm | |
| Left lobe thickness | 15 mm | |
| Left lobe volume | 5.2 ml |
Isthmus
| Isthmus thickness | 3 mm | ≤ 5 |
Total volume
| Total thyroid volume | 10.8 ml | ≤ 18 (women), ≤ 25 (men) |
Gland structure
| Contours | smooth, well defined | |
| Echogenicity | normal | |
| Echotexture | homogeneous | |
| Nodules | none | |
| Vascularity (CDI) | not increased |
Regional lymph nodes
| Regional lymph nodes | not enlarged |
Impression
No sonographic evidence of thyroid pathology. Gland volume within normal limits for age.
Frequent questions
Which formula is used for lobe volume?
The ellipsoid formula: length x width x thickness in centimeters, multiplied by a coefficient (0.479 in this protocol). The service uses the same coefficient for every patient and shows the result in milliliters.
Should the isthmus be included in total volume?
If it is up to 5 mm thick, it is not included. If it is thicker, note it separately and take it into account when interpreting the findings.
How do I describe several nodules?
Each nodule gets its own line with size and characteristics. You can dictate them one after another, and the service will split them into separate rows.
Does the service replace TI-RADS?
No. It records what the physician says. The TI-RADS category is assigned by the physician; the service only puts it into the report without typos.
What it changes on a shift
The thyroid is a typical case where the paperwork takes longer than the scan. Dictation gives that time back to the physician, and the patient leaves with a finished report without waiting until the end of the session.
The first 15 reports are free. After that the price depends on the pack size: from 0.42 to 0.53 USD per report, whatever the length of the dictation. No subscription.
20 reports · 0.53 USD per report50 reports · 0.50 USD per report · -5 %100 reports · 0.48 USD per report · -10 %200 reports · 0.45 USD per report · -15 %500 reports · 0.42 USD per report · -20 %
App file
Point your phone camera: the download page with the file and its checksum.
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