Here are the ultrasound images of my thyroid that were taken at school. The thyroid sits horizontally over the trachea like a saddle with the two lobes connected by a thin isthmus. The cancer nodule is in the top part of the left lobe. It measures about 2 cm x 1.25 cm.
I know most people don't know how to "read" an ultrasound so let me give you a quick primer. Ultrasound works be displaying the echoes of ultrasound (sound above the human range of hearing). Different types of tissue reflect and absorb the sound differently so the returning echoes have different strengths and the computer converts the strength of the echo to the brightness of the spot on the screen. The brighter the spot, the stronger the returned echo. There is more physics involved than this but this is the basic principle.
The displayed image is a cross section of the area being scanned, so imagine its like someone took a thin slice out and that's all you see. It sort of like if you had a stack of pages with each page showing only what you can see at that level of the body and you pulled out one page from the whole stack to look at.
This first picture is a shot horizontally through the left side of the thyroid. It can be a little confusing at first but when you look at an ultrasound image, the patients left is on the right side and their right is on the left. I imagine it is like they are standing in front of me so everything is mirrored. The mass is so big there is only a small amount of normal tissue left on this side. Normally the thyroid has a very fine grain, uniform texture that is medium brightness. The cancerous mass is much darker with a mixed appearance. The bright spots are calcifications which in many cases is indicative of cancer. This machine is old and the printouts aren't very clear but at the imaging clinic where I had the official ultrasounds done it looked like it was packed with glitter.
This is a shot vertically through the left lobe in the center of the mass. There is also a small cyst here. Smooth, round cysts are always benign. I have one on the right side,too (not pictured). One of the other signs of potential malignancy is how well defined and smooth the borders are. You can clearly see the borders on the cyst and they're smooth all the way around. The mass has jagged borders that fade into the surrounding tissue which hints that it is infiltrating the normal tissue.
Our printers only print in greyscale or I'd have a cool picture of the Color Doppler which is used to show blood flow. The mass has a very significant blood supply which means at present it is alive and well with plenty of blood to keep growing.
Someone asked me why, if the cancer was caught "early", they can't just take out the side with the cancer instead of taking out the whole thyroid. They will do that sometimes, but only if it is under 1 cm in diameter. This type of cancer likes to spread throughout the thyroid so at this size it's likely already seeded to the other side but it's not big enough to see on ultrasound yet. The other reason is that if they give me the iodine radiation treatment it will kill the remaining thyroid tissue anyway or if it doesn't it will increase the risk of cancer in the remaining thyroid tissue.
0 comments:
Post a Comment