{"id":35937,"date":"2026-09-10T17:33:09","date_gmt":"2026-09-10T17:33:09","guid":{"rendered":"https:\/\/suresultmed.com\/?p=35937"},"modified":"2026-09-10T17:33:09","modified_gmt":"2026-09-10T17:33:09","slug":"thyroid-nodule-ultrasound-scan","status":"publish","type":"post","link":"https:\/\/suresultmed.com\/ja\/thyroid-nodule-ultrasound-scan\/","title":{"rendered":"Thyroid Nodule Ultrasound: Find It, Measure It, Score It on TI-RADS"},"content":{"rendered":"<div class=\"sr-th-2026\" data-suresult-article-root data-sr-author-voice=\"fernando-mariz-md jailyn-avila-md\">\n<style>body.postid-35937 .wd-page-title.post-title-large-image{background:#fff!important;color:#1b2426!important;min-height:0!important;height:auto!important;padding:44px 0 6px!important}\nbody.postid-35937 .wd-page-title.post-title-large-image .wd-page-title-bg{display:none!important}\nbody.postid-35937 .wd-page-title.post-title-large-image .wd-post-meta,body.postid-35937 .wd-page-title .meta-post-categories,body.postid-35937 .entry-meta{display:none!important}\nbody.postid-35937 .wd-page-title .wd-post-cat{display:none!important}\nbody.postid-35937 .post-featured-image{display:none!important}\nbody.postid-35937 .wd-page-title .container{max-width:1080px!important;width:min(calc(100% - 28px),1080px)!important;padding-inline:0!important;margin-inline:auto!important;align-items:flex-start!important;text-align:left!important}\nbody.postid-35937 .wd-page-title.post-title-large-image .entry-title{color:#1b2426!important;font-family:\"Helvetica Neue\",Arial,system-ui,-apple-system,sans-serif!important;font-weight:800!important;letter-spacing:-.022em!important;line-height:1.04!important;font-size:clamp(34px,5.2vw,60px)!important;text-transform:none!important;max-width:24ch;text-wrap:balance;margin-inline:0}\nbody.postid-35937 .wd-page-title.post-title-large-image .entry-title:before{content:\"Suresult \u00b7 Scan Library \u00b7 September 2026\";display:block;font-family:ui-monospace,\"SF Mono\",\"Cascadia Mono\",Menlo,Consolas,monospace;font-size:12px;font-weight:500;letter-spacing:.18em;text-transform:uppercase;color:#b9791f;margin:0 0 24px}\nbody.postid-35937 .sidebar-container,body.postid-35937 .wd-sidebar,body.postid-35937 .widget-area{display:none!important}\nbody.postid-35937 .wd-content-layout.content-layout-wrapper{display:block!important;width:min(calc(100% - 28px),1240px)!important;max-width:1240px!important;margin-inline:auto!important}\nbody.postid-35937 .wd-content-area.site-content,body.postid-35937 .wd-entry-content{max-width:1120px!important;margin-inline:auto!important;width:100%!important}\n.sr-th-2026{--ink:#1b2426;--ink-soft:#586669;--ink-faint:#8a9698;--rule:#d7dedc;--rule-soft:#e6ebe9;--panel:#fafbfa;--flat:#2f7d78;--flat-soft:#e2efed;--sub:#c98a2b;--sub-soft:#f3e6cf;--sub-line:#b9791f;--mono:ui-monospace,\"SF Mono\",\"Cascadia Mono\",Menlo,Consolas,monospace;--serif:Charter,\"Iowan Old Style\",\"Palatino Linotype\",Georgia,serif;--sans:\"Helvetica Neue\",Arial,system-ui,-apple-system,sans-serif;color:var(--ink);font-family:var(--serif);font-size:19px;line-height:1.68;max-width:1080px;margin:0 auto;padding:0 0 70px;-webkit-font-smoothing:antialiased}\n.sr-th-2026 *{box-sizing:border-box}\n.sr-th-2026 figure{margin:0}\n.sr-th-2026 ::selection{background:var(--sub-soft);color:#1b2426}\n.sr-th-2026 p{margin:0 0 20px;max-width:70ch}\n.sr-th-2026 a{color:var(--flat)!important;font-weight:600;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px}\n.sr-th-2026 a:hover{text-decoration-thickness:2px}\n.sr-th-2026 strong{font-weight:700;color:var(--ink)}\n.sr-th-2026 h2{font-family:var(--sans);font-weight:800;letter-spacing:-.018em;font-size:clamp(25px,3.4vw,34px);line-height:1.1;margin:52px 0 16px;color:var(--ink);text-wrap:balance}\n.sr-th-2026 h3{font-family:var(--sans);font-weight:700;letter-spacing:-.01em;font-size:19px;line-height:1.25;margin:30px 0 10px;color:var(--ink)}\n.sr-th-2026 section[id]{scroll-margin-top:110px}\n.sr-th-2026 a:focus-visible,.sr-th-2026 summary:focus-visible,.sr-th-2026 button:focus-visible{outline:2px solid var(--sub-line);outline-offset:3px;border-radius:2px}\n.sr-th-2026 ::-webkit-scrollbar{height:10px;width:10px}\n.sr-th-2026 ::-webkit-scrollbar-track{background:var(--rule-soft)}\n.sr-th-2026 ::-webkit-scrollbar-thumb{background:#b9c4c2;border-radius:6px;border:2px solid var(--rule-soft)}\n.sr-th-2026 ::-webkit-scrollbar-thumb:hover{background:var(--ink-faint)}\n.sr-th-krow{font-family:var(--mono);font-size:11px;letter-spacing:.16em;text-transform:uppercase;color:var(--sub-line);font-weight:600;display:flex;align-items:center;gap:10px;margin:52px 0 -6px}\n.sr-th-krow:before{content:\"\";width:26px;height:2px;background:var(--sub);flex:0 0 auto}\n.sr-th-krow+h2{margin-top:10px}\n.sr-mast{border-bottom:1px solid var(--ink);padding:2px 0 26px;margin:0 0 8px}\n.sr-th-2026 p.sr-deck{font-family:var(--serif);font-size:clamp(19px,2.2vw,23px);line-height:1.5;color:var(--ink-soft);max-width:44ch;margin:0 0 24px}\n.sr-byline{display:flex;flex-wrap:wrap;gap:8px 22px;align-items:center;font-family:var(--mono);font-size:12.5px;letter-spacing:.02em;color:var(--ink-soft)}\n.sr-byline b{color:var(--ink);font-weight:600}\n.sr-byline br,.sr-byline>p:empty,.sr-author-panel br,.sr-author-panel>p:empty,.sr-author-grid br,.sr-author-grid>p:empty,.sr-author-card br,.sr-author-card>p:empty,.sr-author-card__head br,.sr-author-card__id br,.sr-author-meta br,.sr-th-band__key br,.sr-th-feats br,.sr-th-feat br,.sr-th-tot br,.sr-th-ruler br,.sr-th-rule br,.sr-th-rule__tick br,.sr-th-rt br,.sr-th-figrow br,.sr-light-toc__head br,.sr-light-toc__links br{display:none}\n.sr-byline__author{display:inline-flex;align-items:center;gap:9px}\n.sr-byline__author img{width:30px;height:30px;border-radius:999px;object-fit:cover;border:1px solid var(--rule);background:#fff;flex:0 0 auto}\n.sr-byline__label{display:block;width:100%;font-size:10.5px;letter-spacing:.14em;text-transform:uppercase;color:#637274}\n.sr-verified-badge{color:var(--flat);border:1px solid var(--flat);border-radius:2px;padding:2px 8px;text-transform:uppercase;letter-spacing:.1em;font-size:10.5px;font-weight:600}\n.sr-th-stage{margin:26px 0 0}\n.sr-th-player{position:relative;aspect-ratio:16\/9;background:#04060a;border:1px solid var(--rule);border-radius:4px;overflow:hidden;display:block;width:100%;padding:0;cursor:pointer;transition:box-shadow .45s cubic-bezier(.2,.8,.25,1),transform .45s cubic-bezier(.2,.8,.25,1)}\n.sr-th-player img{width:100%;height:100%;object-fit:cover;display:block;filter:saturate(.9) contrast(1.02);transition:filter .5s cubic-bezier(.2,.8,.25,1),transform .8s cubic-bezier(.2,.8,.25,1)}\n.sr-th-player:hover{transform:translateY(-2px);box-shadow:0 18px 40px -18px rgba(27,36,38,.55)}\n.sr-th-player:hover img{filter:saturate(1.04) contrast(1.05);transform:scale(1.012)}\n.sr-th-player iframe{position:absolute;inset:0;width:100%;height:100%;border:0}\n.sr-th-play{position:absolute;inset:0;display:flex;align-items:center;justify-content:center;pointer-events:none}\n.sr-th-play svg{width:82px;height:82px;filter:drop-shadow(0 6px 20px rgba(0,0,0,.55));transition:transform .45s cubic-bezier(.2,.8,.25,1)}\n.sr-th-player:hover .sr-th-play svg{transform:scale(1.075)}\n.sr-th-play circle{transition:fill .45s ease}\n.sr-th-player:hover .sr-th-play circle{fill:rgba(201,138,43,.94)}\n.sr-th-badge{position:absolute;left:0;bottom:0;display:flex;gap:0;font-family:var(--mono);font-size:11px;letter-spacing:.1em;text-transform:uppercase;pointer-events:none}\n.sr-th-badge span{background:rgba(4,6,10,.82);color:#e8eeec;padding:7px 12px;border-top:1px solid rgba(255,255,255,.14);border-right:1px solid rgba(255,255,255,.14);font-variant-numeric:tabular-nums}\n.sr-th-2026 figcaption.sr-th-cap{font-family:var(--mono);font-size:11.5px;line-height:1.7;color:var(--ink-soft);margin:12px 0 0;max-width:84ch}\n.sr-th-cap b{color:var(--ink-soft);font-weight:600}\n#quick-answer{background:var(--panel);border:1px solid var(--rule);border-left:3px solid var(--sub);border-radius:0 4px 4px 0;padding:26px 28px 12px;margin:34px 0 10px}\n#quick-answer h2{font-family:var(--mono);font-weight:600;font-size:12px;letter-spacing:.18em;text-transform:uppercase;color:var(--sub-line);margin:0 0 16px}\n#quick-answer p{font-size:20px;line-height:1.6;max-width:75ch}\n#quick-answer p strong{background:linear-gradient(transparent 64%,var(--sub-soft) 64%)}\n.sr-th-2026 p.sr-answer-note{font-family:var(--mono);font-size:12px;line-height:1.7;color:var(--ink-soft);border-top:1px solid var(--rule);padding-top:14px;margin-top:4px;max-width:84ch}\n.sr-th-band{background:var(--ink);color:#eef2f1;border-radius:4px;padding:38px 34px 30px;margin:34px 0 0}\n.sr-th-band__eye{font-family:var(--mono);font-size:11px;letter-spacing:.2em;text-transform:uppercase;color:var(--sub);margin:0 0 12px;font-weight:600}\n.sr-th-band h2{color:#fff;margin:0 0 10px;font-size:clamp(24px,3.2vw,32px)}\n.sr-th-2026 p.sr-th-band__sub{color:#a9b8b6;font-size:17px;line-height:1.55;max-width:62ch;margin:0 0 26px}\n.sr-th-feats{display:grid;grid-template-columns:repeat(5,1fr);gap:0;border-top:1px solid rgba(255,255,255,.14);border-bottom:1px solid rgba(255,255,255,.14)}\n.sr-th-feats br,.sr-th-feats>p:empty,.sr-th-feat br,.sr-th-feat>p:empty{display:none}\n.sr-th-2026 .sr-th-feat{display:flex;flex-direction:column;padding:22px 18px 20px;text-decoration:none!important;color:inherit!important;font-weight:400!important;border-left:1px solid rgba(255,255,255,.1);transition:background .25s ease}\n.sr-th-2026 .sr-th-feat:first-child{border-left:0}\n.sr-th-2026 .sr-th-feat:hover{background:rgba(255,255,255,.05)}\n.sr-th-feat__c{display:block;font-family:var(--sans);font-size:15.5px;font-weight:700;color:#fff;line-height:1.2;letter-spacing:-.012em}\n.sr-th-feat__p{display:block;font-family:var(--mono);font-size:10.5px;letter-spacing:.12em;text-transform:uppercase;color:var(--sub);margin:7px 0 12px;font-variant-numeric:tabular-nums}\n.sr-th-feat__w{display:block;font-family:var(--serif);font-size:13.5px;line-height:1.5;color:#a9b8b6;margin:0 0 12px}\n.sr-th-feat__v{display:block;font-family:var(--sans);font-size:13.5px;line-height:1.45;color:#dfe8e6;margin:0 0 16px}\n.sr-th-feat__s{display:flex;align-items:center;gap:9px;margin-top:auto;font-family:var(--mono);font-size:10.5px;letter-spacing:.03em;color:#8b9b99;font-variant-numeric:tabular-nums}\n.sr-th-feat__s i{display:inline-flex;align-items:center;justify-content:center;width:26px;height:26px;border-radius:999px;border:1px solid rgba(240,217,172,.5);background:rgba(201,138,43,.16);color:#f0d9ac;font-style:normal;font-size:13px;font-weight:700;flex:0 0 auto}\n.sr-th-2026 .sr-th-feat:hover .sr-th-feat__s i{background:rgba(201,138,43,.34);border-color:#f0d9ac}\n.sr-th-tot{display:flex;align-items:center;flex-wrap:wrap;gap:14px 18px;margin:26px 0 0;padding:22px 0 0;border-top:1px solid rgba(255,255,255,.14)}\n.sr-th-tot br,.sr-th-tot>p:empty{display:none}\n.sr-th-tot__sum,.sr-th-tot__lvl{display:inline-flex;align-items:baseline;gap:8px}\n.sr-th-tot__sum b{font-family:var(--mono);font-size:34px;line-height:1;font-weight:700;color:#f0d9ac;font-variant-numeric:tabular-nums}\n.sr-th-tot__lvl b{font-family:var(--sans);font-size:25px;line-height:1;font-weight:800;color:#fff;letter-spacing:-.02em}\n.sr-th-tot__sum em,.sr-th-tot__lvl em{font-style:normal;font-family:var(--mono);font-size:10.5px;letter-spacing:.16em;text-transform:uppercase;color:#8b9b99}\n.sr-th-tot__arrow{display:inline-block;width:34px;height:1px;background:rgba(255,255,255,.34);position:relative}\n.sr-th-tot__arrow:after{content:\"\";position:absolute;right:0;top:-3px;width:7px;height:7px;border-top:1px solid rgba(255,255,255,.34);border-right:1px solid rgba(255,255,255,.34);transform:rotate(45deg)}\n.sr-th-tot__out{font-family:var(--sans);font-size:14.5px;line-height:1.45;color:#dfe8e6;flex:1 1 240px;min-width:0}\n.sr-th-ruler{display:block;margin:28px 0 0;padding:22px 0 0;border-top:1px solid rgba(255,255,255,.14)}\n.sr-th-ruler br,.sr-th-ruler>p:empty{display:none}\n.sr-th-rule{display:block;position:relative;height:106px;margin:14px 0 0}\n.sr-th-rule br,.sr-th-rule>p:empty{display:none}\n.sr-th-rule__axis{position:absolute;left:0;right:0;top:68px;height:1px;background:rgba(255,255,255,.28)}\n.sr-th-rule__band{position:absolute;left:0;top:64px;height:9px;background:rgba(63,157,150,.34);border-left:2px solid #3f9d96;border-radius:1px}\n.sr-th-rule__tick{position:absolute;top:0;transform:translateX(-50%);text-align:center;width:120px}\n.sr-th-rule__tick i{position:absolute;left:50%;top:46px;width:1px;height:22px;background:rgba(255,255,255,.42)}\n.sr-th-rule__tick b{display:block;font-family:var(--mono);font-size:11.5px;font-weight:700;color:#e8eeec;font-variant-numeric:tabular-nums;letter-spacing:.03em}\n.sr-th-rule__tick em{display:block;font-style:normal;font-family:var(--mono);font-size:9.5px;line-height:1.4;color:#8b9b99;letter-spacing:.03em;margin-top:3px}\n.sr-th-rule__me{position:absolute;top:82px;transform:translateX(-50%);text-align:center;width:150px}\n.sr-th-rule__me i{position:absolute;left:50%;top:-20px;margin-left:-5px;width:10px;height:10px;border-radius:999px;background:#f0d9ac;box-shadow:0 0 0 4px rgba(240,217,172,.2)}\n.sr-th-rule__me b{display:block;font-family:var(--mono);font-size:11.5px;font-weight:700;color:#f0d9ac;font-variant-numeric:tabular-nums;letter-spacing:.03em}\n.sr-th-2026 p.sr-th-rule__cap{font-family:var(--mono);font-size:11px;line-height:1.75;color:#9aa9a7;margin:8px 0 0;max-width:78ch;text-wrap:pretty}\n.sr-th-rt__seg--score{border-top-color:#7f9c98}\n.sr-th-rt{display:flex;width:100%;margin:24px 0 0;gap:3px}\n.sr-th-rt br,.sr-th-rt>p:empty{display:none}\n.sr-th-rt__seg{display:block;min-width:0;padding:9px 0 0;border-top:3px solid rgba(255,255,255,.28)}\n.sr-th-rt__seg--teach{border-top-color:var(--sub)}\n.sr-th-rt__seg--live{border-top-color:#3f9d96}\n.sr-th-2026 p.sr-th-band__h{font-family:var(--mono);font-size:10.5px;letter-spacing:.16em;text-transform:uppercase;color:#8b9b99;margin:0 0 4px;max-width:none}\n.sr-th-rt__seg b{display:block;font-family:var(--mono);font-size:11px;color:#e8eeec;font-weight:600;font-variant-numeric:tabular-nums;letter-spacing:.03em}\n.sr-th-rt__seg em{display:block;font-style:normal;font-family:var(--mono);font-size:10px;line-height:1.5;color:#8b9b99;letter-spacing:.02em;margin-top:3px}\n.sr-th-rt__seg--close em{display:none}\n.sr-th-2026 p.sr-th-band__key{display:flex;flex-wrap:wrap;gap:8px 24px;font-family:var(--mono);font-size:11px;letter-spacing:.06em;color:#9aa9a7;margin:20px 0 0;max-width:none}\n.sr-th-band__key span{display:inline-flex;align-items:center;gap:8px}\n.sr-th-band__key i{width:14px;height:9px;border-radius:1px;display:inline-block}\n.sr-th-2026 p.sr-th-band__note{font-family:var(--mono);font-size:11px;line-height:1.75;color:#9aa9a7;margin:16px 0 0;max-width:80ch;text-wrap:pretty}\n.sr-th-fig{margin:26px 0 30px;border:1px solid var(--rule);border-radius:4px;overflow:hidden;background:#04060a}\n.sr-th-fig img{display:block;width:100%;height:auto}\n.sr-th-2026 figcaption.sr-th-figcap{font-family:var(--mono);font-size:11.5px;line-height:1.7;color:var(--ink-soft);background:#fff;border-top:1px solid var(--rule);padding:14px 18px;margin:0;max-width:none}\n.sr-th-2026 figcaption.sr-th-figcap b{color:var(--ink);font-weight:600}\n.sr-table-wrap{overflow-x:auto;margin:22px 0 8px;border:1px solid var(--rule);border-radius:4px}\n.sr-th-km{border-collapse:collapse;width:100%;min-width:720px;table-layout:fixed;font-family:var(--sans);font-size:14px}\n.sr-th-km th{font-family:var(--mono);font-size:10.5px;letter-spacing:.13em;text-transform:uppercase;color:#637274;text-align:left;font-weight:600;padding:13px 16px;border-bottom:1px solid var(--rule);background:var(--panel);white-space:nowrap}\n.sr-th-km th:last-child{white-space:normal}\n.sr-th-km td{padding:15px 16px;border-bottom:1px solid var(--rule-soft);vertical-align:top;line-height:1.5;color:var(--ink-soft)}\n.sr-th-km tr:last-child td{border-bottom:0}\n.sr-th-km tr:hover td{background:#fcfdfc}\n.sr-th-2026 .sr-th-t a{font-family:var(--mono);font-size:13px;font-variant-numeric:tabular-nums;color:var(--flat)!important;text-decoration:none;border-bottom:1px solid var(--flat-soft);padding-bottom:1px}\n.sr-th-2026 .sr-th-t a:hover{border-bottom-color:var(--flat)}\n.sr-th-km td b{display:block;font-weight:700;color:var(--ink);font-size:14.5px;margin:0 0 5px}\n.sr-th-screen{display:block}\n.sr-th-set{font-family:var(--mono);font-size:11.5px;line-height:1.75;color:var(--ink-soft);letter-spacing:.01em}\n.sr-th-flag{display:inline-block;font-family:var(--mono);font-size:9.5px;letter-spacing:.11em;text-transform:uppercase;color:var(--sub-line);border:1px solid var(--sub-soft);background:#fdf8ef;border-radius:2px;padding:2px 6px;margin:0 0 6px;font-weight:600}\n.sr-th-2026 p.sr-table-note{font-family:var(--mono);font-size:11.5px;line-height:1.7;color:var(--ink-soft);margin:10px 0 0;max-width:84ch}\n.sr-th-tx{border:1px solid var(--rule);border-radius:4px;margin:22px 0 0;background:#fff}\n.sr-th-tx>summary{font-family:var(--mono);font-size:12px;letter-spacing:.14em;text-transform:uppercase;color:var(--ink-soft);font-weight:600;padding:16px 22px;cursor:pointer;list-style:none;display:flex;align-items:center;justify-content:space-between;gap:14px;background:var(--panel);border-radius:4px}\n.sr-th-tx[open]>summary{border-bottom:1px solid var(--rule);border-radius:4px 4px 0 0}\n.sr-th-tx>summary::-webkit-details-marker{display:none}\n.sr-th-tx>summary:after{content:\"Collapse\";font-size:10.5px;letter-spacing:.1em;color:#637274;font-weight:400}\n.sr-th-tx:not([open])>summary:after{content:\"Read the transcript\"}\n.sr-th-txbody{padding:26px 30px 8px}\n.sr-th-txsec{border-top:1px solid var(--rule-soft);padding-top:20px;margin-top:26px}\n.sr-th-txsec:first-of-type{border-top:0;padding-top:0;margin-top:0}\n.sr-th-txwin{font-family:var(--mono)!important;font-size:10.5px!important;letter-spacing:.15em;text-transform:uppercase;color:var(--sub-line);font-weight:600!important;margin:0 0 12px!important}\n@media (min-width:1000px){.sr-th-txnote span{max-width:74ch;margin-left:188px}.sr-th-txsec{display:grid;grid-template-columns:158px minmax(0,1fr);gap:0 30px;align-items:start}.sr-th-txsec br,.sr-th-txsec>p:empty{display:none}.sr-th-txwin{margin:5px 0 0!important;text-align:right}.sr-th-txcol{max-width:74ch}}\n.sr-th-2026 p.sr-th-txp{font-size:17.5px;line-height:1.72;color:var(--ink-soft);max-width:74ch;margin:0 0 18px}\n.sr-th-2026 a.sr-th-txt{font-family:var(--mono);font-size:11.5px;font-variant-numeric:tabular-nums;color:#2a706c!important;text-decoration:none;background:var(--flat-soft);border-radius:2px;padding:2px 6px;margin-right:10px;letter-spacing:.02em;white-space:nowrap;font-weight:600}\n.sr-th-2026 a.sr-th-txt:hover{background:#215c58;color:#fff!important}\n.sr-th-2026 p.sr-th-txnote{font-family:var(--mono);font-size:11.5px;line-height:1.7;color:var(--ink-soft);margin:0 0 24px;padding:0 0 20px;border-bottom:1px solid var(--rule-soft);max-width:none}\n.sr-th-txnote span{display:block;max-width:84ch}\n.sr-th-dev{border:1px solid var(--rule);border-radius:4px;overflow:hidden;margin:22px 0 0}\n.sr-th-dev__grid{display:grid;grid-template-columns:1fr 1fr}\n.sr-th-dev__grid br,.sr-th-dev__grid>p:empty{display:none}\n.sr-th-dev__col{padding:26px 28px}\n.sr-th-dev__col+.sr-th-dev__col{border-left:1px solid var(--rule);background:var(--panel)}\n.sr-th-2026 p.sr-th-dev__h{font-family:var(--mono);font-size:10.5px;letter-spacing:.14em;text-transform:uppercase;color:#637274;font-weight:600;margin:0 0 16px}\n.sr-th-2026 p.sr-th-dev__name{font-family:var(--sans);font-weight:800;font-size:21px;letter-spacing:-.015em;color:var(--ink);margin:0 0 4px}\n.sr-th-2026 p.sr-th-dev__price{font-family:var(--mono);font-size:12.5px;color:var(--sub-line);margin:0 0 18px;letter-spacing:.03em}\n.sr-th-spec{list-style:none;margin:0;padding:0;font-family:var(--mono);font-size:12px;line-height:1.6;color:var(--ink-soft)}\n.sr-th-spec li{display:grid;grid-template-columns:96px 1fr;gap:14px;padding:8px 0;border-top:1px solid var(--rule-soft)}\n.sr-th-spec li:first-child{border-top:0}\n.sr-th-spec b{color:#637274;font-weight:600;font-size:10.5px;letter-spacing:.09em;text-transform:uppercase;padding-top:1px}\n.sr-th-spec span{font-variant-numeric:tabular-nums}\n.sr-th-dev__links{display:flex;flex-wrap:wrap;gap:10px 14px;padding:18px 28px;border-top:1px solid var(--rule);background:#fff;font-family:var(--mono);font-size:12px}\n.sr-th-dev__links br,.sr-th-dev__links>p:empty{display:none}\n.sr-th-2026 .sr-th-dev__links a{text-decoration:none;border:1px solid var(--rule);border-radius:3px;padding:9px 14px;color:var(--flat)!important;letter-spacing:.03em;transition:border-color .2s ease,background .2s ease}\n.sr-th-2026 .sr-th-dev__links a:hover{border-color:var(--flat);background:#eef6f4;color:#2a706c!important}\n.sr-th-rels{display:grid;grid-template-columns:repeat(4,1fr);gap:18px;margin:22px 0 0}\n.sr-th-rels br,.sr-th-rels>p:empty{display:none}\n.sr-th-2026 .sr-th-rel{display:block;text-decoration:none!important;color:inherit!important;border:1px solid var(--rule);border-radius:4px;overflow:hidden;font-weight:400!important;transition:border-color .25s ease,transform .25s cubic-bezier(.2,.8,.25,1),box-shadow .25s ease}\n.sr-th-2026 .sr-th-rel:hover{border-color:var(--ink-faint);transform:translateY(-2px);box-shadow:0 12px 26px -16px rgba(27,36,38,.5)}\n.sr-th-rel__img{display:block;position:relative;aspect-ratio:16\/9;background:#04060a}\n.sr-th-rel__img img{width:100%;height:100%;object-fit:cover;display:block}\n.sr-th-rel__len{position:absolute;right:8px;bottom:8px;font-family:var(--mono);font-size:10.5px;background:rgba(4,6,10,.86);color:#e8eeec;padding:3px 7px;border-radius:2px;font-variant-numeric:tabular-nums}\n.sr-th-rel__b{display:block;padding:16px 18px 18px}\n.sr-th-rel__t{display:block;font-family:var(--sans);font-weight:700;font-size:15.5px;line-height:1.3;color:var(--ink);margin:0 0 7px;letter-spacing:-.01em}\n.sr-th-rel__d{display:block;font-size:14.5px;line-height:1.55;color:var(--ink-soft);margin:0 0 12px}\n.sr-th-rel__cta{display:block;font-family:var(--mono);font-size:11px;letter-spacing:.1em;text-transform:uppercase;color:var(--flat);font-weight:600}\n.sr-th-2026 p.sr-th-hublink{font-family:var(--mono);font-size:12px;color:var(--ink-soft);margin:18px 0 0;max-width:84ch}\n.sr-th-q{border-bottom:1px solid var(--rule-soft);padding:0}\n.sr-th-q:first-of-type{border-top:1px solid var(--rule-soft)}\n.sr-th-q>summary{font-family:var(--sans);font-weight:700;font-size:17px;color:var(--ink);padding:18px 34px 18px 0;cursor:pointer;list-style:none;position:relative;line-height:1.35}\n.sr-th-q>summary::-webkit-details-marker{display:none}\n.sr-th-q>summary:after{content:\"\";position:absolute;right:8px;top:50%;width:9px;height:9px;border-right:1.5px solid var(--ink-faint);border-bottom:1.5px solid var(--ink-faint);transform:translateY(-70%) rotate(45deg);transition:transform .25s ease}\n.sr-th-q[open]>summary:after{transform:translateY(-30%) rotate(225deg)}\n.sr-th-q p{margin:0 0 12px;color:var(--ink-soft);font-size:17px;max-width:75ch}\n.sr-th-cite{display:block;font-family:var(--mono);font-size:11px;color:var(--ink-soft);line-height:1.7;padding:0 0 20px;max-width:80ch}\n.sr-th-src{list-style:none;margin:22px 0 0;padding:0;font-family:var(--mono);font-size:12px;line-height:1.7}\n.sr-th-src li{padding:14px 0;border-top:1px solid var(--rule-soft)}\n.sr-th-src li span{display:block;color:var(--ink-soft);margin-top:4px;max-width:88ch}\n.sr-final-cta{background:var(--ink);color:#eef2f1;border-radius:4px;padding:38px 34px 34px;margin:52px 0 0;display:grid;grid-template-columns:minmax(0,1fr) 300px;gap:34px;align-items:center}\n.sr-final-cta br,.sr-final-cta>p:empty{display:none}\n.sr-final-cta h2{color:#fff!important;margin:0 0 12px!important;font-size:clamp(22px,3vw,29px)!important}\n.sr-th-2026 .sr-final-cta p{color:#a9b8b6;font-size:16.5px;line-height:1.6;margin:0;max-width:56ch}\n.sr-chat-link{display:block}\n.sr-crisp-consult-btn{position:relative;display:inline-flex;align-items:center;justify-content:center;gap:9px;width:100%;min-height:48px;border:0;border-radius:4px;background:linear-gradient(135deg,#39e889 0%,#22c55e 52%,#00c853 100%);color:#fff;font-family:var(--mono);font-size:12px;font-weight:700;letter-spacing:.04em;line-height:1.1;padding:13px 16px;box-shadow:0 8px 18px rgba(34,197,94,.24);animation:srBlBreath 2.65s ease-in-out infinite;cursor:pointer}\n.sr-crisp-consult-btn:before{content:\"\";width:8px;height:8px;border-radius:999px;background:#ecfff3;box-shadow:0 0 0 0 rgba(236,255,243,.78),0 0 9px rgba(236,255,243,.86);animation:srBlDotPulse 1.8s ease-out infinite}\n@keyframes srBlBreath{0%,100%{transform:translateY(0);box-shadow:0 8px 18px rgba(34,197,94,.24),0 0 0 0 rgba(34,197,94,.2)}50%{transform:translateY(-1px);box-shadow:0 12px 24px rgba(34,197,94,.34),0 0 0 7px rgba(34,197,94,.08)}}\n@keyframes srBlDotPulse{0%{box-shadow:0 0 0 0 rgba(236,255,243,.76),0 0 9px rgba(236,255,243,.85)}70%{box-shadow:0 0 0 8px rgba(236,255,243,0),0 0 12px rgba(236,255,243,.65)}100%{box-shadow:0 0 0 0 rgba(236,255,243,0),0 0 9px rgba(236,255,243,.85)}}\n.sr-author-panel{margin:20px 0 0}\n.sr-th-2026 p.sr-byline__label{margin:0;max-width:none}\n.sr-author-grid{display:grid;grid-template-columns:1fr 1fr;gap:0 30px;margin:10px 0 14px}\n.sr-author-card{border-top:1px solid var(--rule);padding:13px 0 4px;min-width:0}\n.sr-author-card__head{display:flex;align-items:center;gap:11px}\n.sr-author-card__head img{width:42px;height:42px;border-radius:999px;object-fit:cover;border:1px solid var(--rule);background:#fff;flex:0 0 auto}\n.sr-author-card__id{display:flex;flex-direction:column;min-width:0}\n.sr-th-2026 .sr-author-card__id b{font-family:var(--sans);font-size:15px;font-weight:700;color:var(--ink);letter-spacing:-.006em;line-height:1.2}\n.sr-author-card__role{font-family:var(--mono);font-size:10.5px;letter-spacing:.05em;color:#637274;line-height:1.4;margin-top:3px}\n.sr-th-2026 .sr-author-card details{margin:9px 0 0}\n.sr-th-2026 .sr-author-card summary{font-family:var(--mono);font-size:10.5px;letter-spacing:.13em;text-transform:uppercase;color:var(--flat);font-weight:600;cursor:pointer;list-style:none;display:inline-flex;align-items:center;gap:8px;padding:2px 0}\n.sr-th-2026 .sr-author-card summary::-webkit-details-marker{display:none}\n.sr-th-2026 .sr-author-card summary:after{content:\"+\";font-family:var(--sans);font-size:13px;line-height:1;color:var(--ink-faint);font-weight:400}\n.sr-th-2026 .sr-author-card details[open] summary:after{content:\"\u00813\"}\n.sr-th-2026 .sr-author-card details p{margin:10px 0 0;color:var(--ink-soft);font-size:15px;line-height:1.6;max-width:62ch}\n.sr-th-2026 p.sr-author-card__links{font-family:var(--mono);font-size:11px;letter-spacing:.03em;margin:10px 0 2px;color:var(--ink-faint);max-width:none}\n.sr-author-meta{display:flex;flex-wrap:wrap;gap:8px 20px;align-items:center;font-family:var(--mono);font-size:12.5px;letter-spacing:.02em;color:var(--ink-soft)}\n.sr-th-2026 p.sr-author-meta{margin:0;max-width:none}\n.sr-author-meta b{color:var(--ink);font-weight:600}\n.sr-light-toc{display:none;position:fixed;top:140px;left:calc(50% + 640px);width:300px;z-index:20;background:#fff;border:1px solid #d7dedc;border-radius:4px;padding:18px 18px 16px;max-height:calc(100vh - 190px);overflow:auto;font-family:ui-monospace,\"SF Mono\",\"Cascadia Mono\",Menlo,Consolas,monospace}\n.sr-light-toc__head{display:flex;align-items:baseline;justify-content:space-between;gap:10px;margin:0 0 10px}\n.sr-th-2026 .sr-light-toc__title{font-size:11px;letter-spacing:.18em;text-transform:uppercase;color:#b9791f;margin:0;font-weight:600}\n.sr-th-2026 .sr-light-toc__progress{font-size:10px;color:#637274;letter-spacing:.06em;font-variant-numeric:tabular-nums}\n.sr-light-toc__links{display:flex;flex-direction:column;counter-reset:toc}\n.sr-th-2026 .sr-light-toc__links a{counter-increment:toc;display:flex;align-items:baseline;gap:10px;font-size:12px;line-height:1.35;color:#586669!important;text-decoration:none;font-weight:400;padding:6px 8px 6px 10px;border-left:2px solid #e6ebe9}\n.sr-th-2026 .sr-light-toc__links a:before{content:counter(toc,decimal-leading-zero);font-size:9.5px;color:#637274;letter-spacing:.06em;min-width:18px;flex:0 0 auto}\n.sr-th-2026 .sr-light-toc__links a:hover{color:#1b2426!important;border-left-color:#c98a2b}\n.sr-th-2026 .sr-light-toc__links a.sr-toc-active{color:#1b2426!important;border-left-color:#c98a2b;font-weight:600}\n.sr-th-2026 p.sr-light-toc__note{font-family:Charter,\"Iowan Old Style\",Georgia,serif;font-size:13.5px;line-height:1.5;color:#586669;margin:14px 0 10px;max-width:none}\n@media (min-width:1420px) and (max-width:1919px){body.postid-35937 .wd-content-area.site-content,body.postid-35937 .wd-entry-content{max-width:1180px!important}.sr-th-2026{max-width:1180px}.sr-light-toc{display:block;left:auto;right:4px;width:114px;padding:12px 7px}.sr-th-2026 .sr-light-toc__links a{font-size:9.5px;padding:5px 3px}.sr-th-2026 p.sr-light-toc__note{font-size:11px}.sr-light-toc .sr-crisp-consult-btn{font-size:9px;padding:10px 3px}.sr-th-2026 .sr-light-toc__progress{font-size:9px}}\n@media (min-width:1920px){.sr-light-toc{display:block}body.postid-35937 .wd-content-area.site-content,body.postid-35937 .wd-entry-content{max-width:1200px!important}.sr-th-2026{max-width:1200px}}\n@media (max-width:900px){.sr-author-grid{grid-template-columns:1fr;gap:0}.sr-th-dev__grid{grid-template-columns:1fr}.sr-th-dev__col+.sr-th-dev__col{border-left:0;border-top:1px solid var(--rule)}.sr-th-rels{grid-template-columns:1fr 1fr}.sr-final-cta{grid-template-columns:1fr;gap:24px}.sr-th-feats{grid-template-columns:repeat(2,1fr)}.sr-th-2026 .sr-th-feat{border-left:0;border-top:1px solid rgba(255,255,255,.1)}.sr-th-2026 .sr-th-feat:nth-child(odd){border-right:1px solid rgba(255,255,255,.1)}.sr-th-2026 .sr-th-feat:first-child,.sr-th-2026 .sr-th-feat:nth-child(2){border-top:0}.sr-th-rule__tick em{display:none}}\n@media (max-width:640px){.sr-th-2026{font-size:18px;padding:0 0 60px}.sr-byline__author{width:100%;align-items:center;flex-wrap:wrap;gap:6px 10px}.sr-byline b{white-space:nowrap}.sr-byline{gap:12px 18px}.sr-th-badge__x{display:none}.sr-th-feats{grid-template-columns:1fr}.sr-th-2026 .sr-th-feat{border-left:0;padding:20px 18px}.sr-th-2026 .sr-th-feat:nth-child(odd){border-right:0}.sr-th-2026 .sr-th-feat+.sr-th-feat{border-top:1px solid rgba(255,255,255,.1)}.sr-th-rule{height:120px}.sr-th-rule__tick{width:82px}.sr-th-rule__tick b{font-size:10px}.sr-th-rule__me{width:110px}.sr-th-tot__out{flex:1 1 100%}.sr-th-rt__seg em{display:none}.sr-th-band{padding:28px 20px 24px}.sr-th-rels{grid-template-columns:1fr}.sr-th-txbody{padding:20px 18px 4px}.sr-th-dev__col{padding:22px 20px}.sr-th-dev__links{padding:16px 20px}.sr-th-dev__links a{flex:1 1 auto;text-align:center}#quick-answer{padding:22px 20px 8px}#quick-answer p{font-size:18.5px}.sr-final-cta{padding:28px 20px 26px}.sr-th-spec li{grid-template-columns:1fr;gap:2px}.sr-th-feat__c{font-size:15px}.sr-th-play svg{width:62px;height:62px}}\n@media (prefers-reduced-motion:reduce){.sr-th-2026 *,.sr-light-toc *{animation-duration:.001ms!important;animation-iteration-count:1!important;transition-duration:.001ms!important}}<\/style>\n<div class=\"sr-mast\">\n<p class=\"sr-deck\">A thyroid run end to end on the linear side of a three-in-one head &mdash; sweep the lobe in two planes, separate a nodule from a vessel and both from a shadow, measure it in three axes off the cine buffer, then score it &mdash; with every moment timestamped and the whole recording transcribed.<\/p>\n<div class=\"sr-author-panel\" data-suresult-author-panel aria-label=\"Article authors\">\n<p class=\"sr-byline__label\">Written and clinically reviewed by<\/p>\n<div class=\"sr-author-grid\">\n<article class=\"sr-author-card\" data-sr-author=\"fernando-mariz-md\">\n<div class=\"sr-author-card__head\"><img src=\"https:\/\/suresultmed.com\/wp-content\/uploads\/fernando-mariz-md-author-avatar.png\" alt=\"Fernando Mariz, MD\" width=\"42\" height=\"42\" loading=\"lazy\" decoding=\"async\"><span class=\"sr-author-card__id\"><b>Fernando Mariz, MD<\/b><span class=\"sr-author-card__role\">Gynecology, pelvic surgery, sonography<\/span><\/span><\/div>\n<details data-sr-author-bio>\n<summary>About Dr. Mariz<\/summary>\n<p>I am Dr. Fernando Mariz, a gynecology and pelvic surgery physician practicing in New York City. Before my medical career, I served in the U.S. Marine Corps, where I developed the discipline, focus, and steadiness that continue to shape the way I care for patients today. At Maiden Lane Medical, my work covers women&rsquo;s health, preventive care, sonography, pelvic pain, abnormal uterine bleeding, and minimally invasive gynecologic procedures.<\/p>\n<p class=\"sr-author-card__links\"><a href=\"https:\/\/maidenlanemedical.com\/profile\/fernando-mariz-md\/\" target=\"_blank\" rel=\"noopener noreferrer nofollow\">Maiden Lane Medical profile<\/a> &middot; <a href=\"https:\/\/weillcornell.org\/fernando-marizmd-9639\" target=\"_blank\" rel=\"noopener noreferrer nofollow\">Weill Cornell Medicine<\/a><\/p>\n<\/details>\n<\/article>\n<article class=\"sr-author-card\" data-sr-author=\"jailyn-avila-md\">\n<div class=\"sr-author-card__head\"><img src=\"https:\/\/suresultmed.com\/wp-content\/uploads\/jailyn-avila-md-author-avatar.png\" alt=\"Jailyn Avila, MD\" width=\"42\" height=\"42\" loading=\"lazy\" decoding=\"async\"><span class=\"sr-author-card__id\"><b>Jailyn Avila, MD<\/b><span class=\"sr-author-card__role\">Emergency medicine, POCUS education<\/span><\/span><\/div>\n<details data-sr-author-bio>\n<summary>About Dr. Avila<\/summary>\n<p>I am Dr. Jailyn Avila, an emergency medicine physician, educator, and digital health innovator based in Southern California. My clinical work is rooted in emergency care, while my teaching focuses on point-of-care ultrasound, residency education, and practical training for physicians. Through my roles with Emergent Medical Associates, UHS SoCal MEC Emergency Medicine Residency, Core Ultrasound, and FemInEM, I work at the intersection of patient care, medical education, and accessible digital learning.<\/p>\n<p class=\"sr-author-card__links\"><a href=\"https:\/\/jailynavila.com\/\" target=\"_blank\" rel=\"noopener noreferrer nofollow\">Personal site<\/a> &middot; <a href=\"https:\/\/feminem.org\/about\" target=\"_blank\" rel=\"noopener noreferrer nofollow\">FemInEM<\/a><\/p>\n<\/details>\n<\/article>\n<\/div>\n<p class=\"sr-author-meta\"><span class=\"sr-verified-badge\">Verified authors<\/span><span>Updated <b>September 10, 2026<\/b><\/span><\/p>\n<\/div>\n<\/div>\n<figure class=\"sr-th-stage\">\n<button class=\"sr-th-player\" id=\"sr-th-player\" type=\"button\" aria-label=\"Play the thyroid nodule walkthrough, 13 minutes 45 seconds\"><br \/>\n<img src=\"https:\/\/suresultmed.com\/wp-content\/uploads\/thyroid-nodule-transverse-gland-poster.jpg\" alt=\"Transverse thyroid image on a Suresult D3Ultra: thyroid tissue with the adjacent artery in cross-section and a small round anechoic nodule inside the gland, frozen at 40 mm depth and H10.0 MHz on the Thyroid preset\" width=\"1300\" height=\"905\" fetchpriority=\"high\" decoding=\"async\"><br \/>\n<span class=\"sr-th-play\"><svg viewBox=\"0 0 84 84\" aria-hidden=\"true\" focusable=\"false\"><circle cx=\"42\" cy=\"42\" r=\"40\" fill=\"rgba(10,14,18,.62)\" stroke=\"rgba(255,255,255,.9)\" stroke-width=\"1.6\"\/><path d=\"M34.5 28.2 L58 42 L34.5 55.8 Z\" fill=\"#fff\"\/><\/svg><\/span><br \/>\n<span class=\"sr-th-badge\"><span>13:45<\/span><span class=\"sr-th-badge__k\">13 key moments<\/span><span class=\"sr-th-badge__x\">Transcript below<\/span><\/span><br \/>\n<\/button><figcaption class=\"sr-th-cap\"><b>Brandon Ramakko, DC scans his own thyroid here, on a D3Ultra; the clip went up on the Suresult channel on 12 October 2025.<\/b> The poster is frozen at 7:58, the moment the nodule is found; the two frames further down are 5:36 and 6:40 of the same scan.<\/figcaption><\/figure>\n<section id=\"quick-answer\">\n<h2>Quick answer<\/h2>\n<p><strong>A thyroid nodule is a discrete focus that starts and stops inside otherwise uniform gland, and what decides the next step is never one look at it &mdash; it is five scored features plus one measurement.<\/strong> Put the linear array on the front of the neck, lower than instinct says, because the gland sits well below the thyroid cartilage rather than at it. Sweep the lobe in two planes at about 40 mm of depth. A nodule appears, grows and vanishes within a few millimetres of travel; a vessel keeps running as you follow it, and fills on colour or power Doppler. Once you have one, measure it in three axes off the cine buffer and score it: composition, echogenicity, shape, margin, echogenic foci. The points are added, the total lands in one of five ACR levels, and each level carries its own biopsy size and its own follow-up size. The nodule scanned in this recording totals zero points and measures 4 &times; 4 &times; 5 mm, which is benign with no needle and no follow-up scan. <strong>I would learn the sweep before the score<\/strong>, because a score is worthless applied to something you have not really found, and the two artefacts on screen here &mdash; a dark column that looks like a cleft, and an edge effect beside a vessel &mdash; are exactly what gets scored by mistake. Start at 4:20 for the scanning and 9:33 for the scoring.<\/p>\n<p class=\"sr-answer-note\">If the question is the hardware rather than the exam, the <a href=\"https:\/\/suresultmed.com\/specialty\/handheld-ultrasound-for-endocrinology\/\">endocrinology hub<\/a> covers what small-parts work asks of a probe, and the <a href=\"https:\/\/suresultmed.com\/shop\/handheld-ultrasounds\/d3ultra-multipurpose-handheld-ultrasound\/\">D3Ultra page<\/a> carries the full specification and the current price.<\/p>\n<\/section>\n<section id=\"scorecard\">\n<div class=\"sr-th-band\">\n<p class=\"sr-th-band__eye\">Scored on camera<\/p>\n<h2>Five features, one total, one decision<\/h2>\n<p class=\"sr-th-band__sub\">The American College of Radiology system scores five things about a nodule and adds the points up. Here is what each category can contribute, and what this nodule was called in each. Every card jumps the video to the moment it is argued.<\/p>\n<div class=\"sr-th-feats\"><a class=\"sr-th-feat\" href=\"#t=612\" data-sr-seek=\"612\"><span class=\"sr-th-feat__c\">Composition<\/span><span class=\"sr-th-feat__p\">0\u20132 pt<\/span><span class=\"sr-th-feat__w\">Cystic and spongiform score nothing. Mixed scores one, solid scores two.<\/span><span class=\"sr-th-feat__v\">Called cystic on camera.<\/span><span class=\"sr-th-feat__s\"><i>0<\/i>scored at 10:12<\/span><\/a><a class=\"sr-th-feat\" href=\"#t=644\" data-sr-seek=\"644\"><span class=\"sr-th-feat__c\">Echogenicity<\/span><span class=\"sr-th-feat__p\">0\u20133 pt<\/span><span class=\"sr-th-feat__w\">Judged against the parenchyma around it, from anechoic up to very hypoechoic.<\/span><span class=\"sr-th-feat__v\">Called anechoic, black against the gland.<\/span><span class=\"sr-th-feat__s\"><i>0<\/i>scored at 10:44<\/span><\/a><a class=\"sr-th-feat\" href=\"#t=649\" data-sr-seek=\"649\"><span class=\"sr-th-feat__c\">Shape<\/span><span class=\"sr-th-feat__p\">0\u20133 pt<\/span><span class=\"sr-th-feat__w\">Only taller-than-wide scores, judged on the transverse image.<\/span><span class=\"sr-th-feat__v\">4 mm front to back against 5 mm along the gland.<\/span><span class=\"sr-th-feat__s\"><i>0<\/i>scored at 10:49<\/span><\/a><a class=\"sr-th-feat\" href=\"#t=673\" data-sr-seek=\"673\"><span class=\"sr-th-feat__c\">Margin<\/span><span class=\"sr-th-feat__p\">0\u20133 pt<\/span><span class=\"sr-th-feat__w\">Smooth and ill-defined score nothing. Lobulated, irregular and extra-thyroidal score.<\/span><span class=\"sr-th-feat__v\">Smooth in one plane, a little irregular in the other.<\/span><span class=\"sr-th-feat__s\"><i>0<\/i>scored at 11:13<\/span><\/a><a class=\"sr-th-feat\" href=\"#t=695\" data-sr-seek=\"695\"><span class=\"sr-th-feat__c\">Echogenic foci<\/span><span class=\"sr-th-feat__p\">0\u20133 pt<\/span><span class=\"sr-th-feat__w\">Calcifications and punctate foci add points. Nothing to see adds none.<\/span><span class=\"sr-th-feat__v\">No calcification and no comet-tails.<\/span><span class=\"sr-th-feat__s\"><i>0<\/i>scored at 11:35<\/span><\/a><\/div>\n<div class=\"sr-th-tot\"><span class=\"sr-th-tot__sum\"><b>0<\/b><em>points<\/em><\/span><span class=\"sr-th-tot__arrow\" aria-hidden=\"true\"><\/span><span class=\"sr-th-tot__lvl\"><b>TR1<\/b><em>benign<\/em><\/span><span class=\"sr-th-tot__out\">No biopsy and no imaging follow-up, at any size.<\/span><\/div>\n<div class=\"sr-th-ruler\">\n<p class=\"sr-th-band__h\">Where 5 mm sits against the published thresholds<\/p>\n<div class=\"sr-th-rule\"><span class=\"sr-th-rule__axis\"><\/span><span class=\"sr-th-rule__band\" style=\"width:35.71%\"><\/span><span class=\"sr-th-rule__tick\" style=\"left:17.86%\"><i><\/i><b>0.5 cm<\/b><em>TR5 follow<\/em><\/span><span class=\"sr-th-rule__tick\" style=\"left:35.71%\"><i><\/i><b>1.0 cm<\/b><em>TR5 biopsy \u00b7 TR4 follow<\/em><\/span><span class=\"sr-th-rule__tick\" style=\"left:53.57%\"><i><\/i><b>1.5 cm<\/b><em>TR4 biopsy \u00b7 TR3 follow<\/em><\/span><span class=\"sr-th-rule__tick\" style=\"left:89.29%\"><i><\/i><b>2.5 cm<\/b><em>TR3 biopsy<\/em><\/span><span class=\"sr-th-rule__me\" style=\"left:17.86%\"><i><\/i><b>4 \u00d7 4 \u00d7 5 mm<\/b><\/span><\/div>\n<p class=\"sr-th-rule__cap\">The teal run is where no level in the system recommends a biopsy. Inside it, only the top level asks for follow-up imaging, and only from 0.5 cm.<\/p>\n<\/div>\n<div class=\"sr-th-rt\"><span class=\"sr-th-rt__seg sr-th-rt__seg--teach\" style=\"width:30.6%\"><b>0:11<\/b><em>Why, on whom, and with what<\/em><\/span><span class=\"sr-th-rt__seg sr-th-rt__seg--live\" style=\"width:36.0%\"><b>4:20<\/b><em>The gland scanned and the nodule measured<\/em><\/span><span class=\"sr-th-rt__seg sr-th-rt__seg--score\" style=\"width:28.3%\"><b>9:13<\/b><em>Scored, and what the score buys you<\/em><\/span><span class=\"sr-th-rt__seg sr-th-rt__seg--close\" style=\"width:5.2%\"><b>13:03<\/b><em>Close<\/em><\/span><\/div>\n<p class=\"sr-th-band__key\"><span><i style=\"background:#c98a2b\"><\/i>why, on whom, and with what<\/span><span><i style=\"background:#3f9d96\"><\/i>the gland scanned, the nodule measured<\/span><span><i style=\"background:#7f9c98\"><\/i>scored<\/span><span><i style=\"background:rgba(255,255,255,.28)\"><\/i>close<\/span><\/p>\n<p class=\"sr-th-band__note\">The chart itself belongs to the ACR and is linked under Sources rather than reproduced here. Two things about this case deserve saying plainly. It is Ramakko&rsquo;s own thyroid, which he says at 0:20, so the case is a volunteer with a known nodule rather than a referral. And that nodule is anechoic, smooth and 5 mm, which is the easy end of all five scales at once. A solid, very hypoechoic, taller-than-wide nodule with punctate foci scores eleven, lands in the top level, and is sampled from 1 cm. The system earns its keep on that one, not on this one.<\/p>\n<\/div>\n<\/section>\n<section id=\"key-moments\">\n<p class=\"sr-th-krow\">Timestamped<\/p>\n<h2>Key moments, with the settings<\/h2>\n<p>The third column is the part a scan video usually leaves out: the preset, depth, frequency and gain showing on the device panel at that moment. On this recording they are chosen before the first sweep and then never touched again &mdash; one preset, one depth, one frequency, one gain, for the whole gland. The only control that moves at all is compound imaging, switched on at 6:18 and off again before the sweep resumes.<\/p>\n<div class=\"sr-table-wrap\">\n<table class=\"sr-th-km\">\n<colgroup>\n<col style=\"width:82px\">\n<col>\n<col style=\"width:268px\"><\/colgroup>\n<thead>\n<tr>\n<th>Time<\/th>\n<th>What is on screen<\/th>\n<th>Transducer, depth, frequency, gain<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td class=\"sr-th-t\"><a href=\"#t=11\" data-sr-seek=\"11\">0:11<\/a><\/td>\n<td><b>Why scan a thyroid, and whose nodule this is<\/b><span class=\"sr-th-screen\">Presenter to camera with the probe in hand<\/span><\/td>\n<td class=\"sr-th-set\">\u2014<\/td>\n<\/tr>\n<tr>\n<td class=\"sr-th-t\"><a href=\"#t=48\" data-sr-seek=\"48\">0:48<\/a><\/td>\n<td><b>Positioning the patient, and where your arm ends up<\/b><span class=\"sr-th-screen\">Presenter to camera<\/span><\/td>\n<td class=\"sr-th-set\">\u2014<\/td>\n<\/tr>\n<tr>\n<td class=\"sr-th-t\"><a href=\"#t=123\" data-sr-seek=\"123\">2:03<\/a><\/td>\n<td><b>The linear side, and the frequency band he asks for<\/b><span class=\"sr-th-screen\">Presenter to camera<\/span><\/td>\n<td class=\"sr-th-set\">\u2014<\/td>\n<\/tr>\n<tr>\n<td class=\"sr-th-t\"><a href=\"#t=155\" data-sr-seek=\"155\">2:35<\/a><\/td>\n<td><b>What a point-of-care study documents, and screening in two planes<\/b><span class=\"sr-th-screen\">Presenter to camera<\/span><\/td>\n<td class=\"sr-th-set\">\u2014<\/td>\n<\/tr>\n<tr>\n<td class=\"sr-th-t\"><a href=\"#t=260\" data-sr-seek=\"260\">4:20<\/a><\/td>\n<td><b>First look: uniform gland, and the artery beside it<\/b><span class=\"sr-th-flag\">live scan<\/span><span class=\"sr-th-screen\">Live transverse image of the gland on the device panel<\/span><\/td>\n<td class=\"sr-th-set\">Linear \u00b7 Thyroid preset \u00b7 D 40 mm \u00b7 F H10.0 MHz<\/td>\n<\/tr>\n<tr>\n<td class=\"sr-th-t\"><a href=\"#t=296\" data-sr-seek=\"296\">4:56<\/a><\/td>\n<td><b>Vessel or nodule: follow it through, then reach for Doppler<\/b><span class=\"sr-th-flag\">live scan<\/span><span class=\"sr-th-screen\">Screening superior to inferior through the lobe<\/span><\/td>\n<td class=\"sr-th-set\">Linear \u00b7 D 40 mm \u00b7 GN 86 dB \u00b7 DR 60<\/td>\n<\/tr>\n<tr>\n<td class=\"sr-th-t\"><a href=\"#t=332\" data-sr-seek=\"332\">5:32<\/a><\/td>\n<td><b>A dark band that is an artefact, not a cleft in the gland<\/b><span class=\"sr-th-flag\">live scan<\/span><span class=\"sr-th-screen\">Edge shadowing beside the vessel, then fascial shadowing in the gland<\/span><\/td>\n<td class=\"sr-th-set\">Linear \u00b7 D 40 mm \u00b7 ENH 0 \u00b7 Compound OFF<\/td>\n<\/tr>\n<tr>\n<td class=\"sr-th-t\"><a href=\"#t=378\" data-sr-seek=\"378\">6:18<\/a><\/td>\n<td><b>Compound imaging switched on, then straight back off<\/b><span class=\"sr-th-flag\">live scan<\/span><span class=\"sr-th-screen\">The parameter column flips to Compound ON, then to OFF<\/span><\/td>\n<td class=\"sr-th-set\">Linear \u00b7 Compound ON then OFF \u00b7 F H10.0 MHz<\/td>\n<\/tr>\n<tr>\n<td class=\"sr-th-t\"><a href=\"#t=422\" data-sr-seek=\"422\">7:02<\/a><\/td>\n<td><b>Screening the whole lobe, and the circle that winks in and out<\/b><span class=\"sr-th-flag\">live scan<\/span><span class=\"sr-th-screen\">A small anechoic focus appearing and disappearing on the sweep<\/span><\/td>\n<td class=\"sr-th-set\">Linear \u00b7 D 40 mm \u00b7 MI 0.9 \u00b7 TIS 0.2<\/td>\n<\/tr>\n<tr>\n<td class=\"sr-th-t\"><a href=\"#t=455\" data-sr-seek=\"455\">7:35<\/a><\/td>\n<td><b>Cine review, then the first two lengths<\/b><span class=\"sr-th-flag\">live scan<\/span><span class=\"sr-th-screen\">Frozen frame stepped through the cine buffer, calipers placed twice<\/span><\/td>\n<td class=\"sr-th-set\">Linear \u00b7 FREEZE \u00b7 cine review \u00b7 D 40 mm<\/td>\n<\/tr>\n<tr>\n<td class=\"sr-th-t\"><a href=\"#t=513\" data-sr-seek=\"513\">8:33<\/a><\/td>\n<td><b>The second axis, and the size verdict<\/b><span class=\"sr-th-flag\">live scan<\/span><span class=\"sr-th-screen\">The same nodule in the orthogonal plane, measured once more<\/span><\/td>\n<td class=\"sr-th-set\">Linear \u00b7 FREEZE \u00b7 D 40 mm \u00b7 F H10.0 MHz<\/td>\n<\/tr>\n<tr>\n<td class=\"sr-th-t\"><a href=\"#t=573\" data-sr-seek=\"573\">9:33<\/a><\/td>\n<td><b>ACR TI-RADS, scored live: five categories, five zeroes<\/b><span class=\"sr-th-screen\">Presenter to camera, working down the categories<\/span><\/td>\n<td class=\"sr-th-set\">\u2014<\/td>\n<\/tr>\n<tr>\n<td class=\"sr-th-t\"><a href=\"#t=735\" data-sr-seek=\"735\">12:15<\/a><\/td>\n<td><b>Follow-up in practice, and one nodule that went away<\/b><span class=\"sr-th-screen\">Presenter to camera<\/span><\/td>\n<td class=\"sr-th-set\">\u2014<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<p class=\"sr-table-note\">Settings transcribed from the device panel visible in the recording: D is depth, F is transmit frequency and GN is gain. The four rows before 4:20 and the two after 9:33 are argued to camera with no panel on screen.<\/p>\n<\/section>\n<section id=\"what-it-shows\">\n<p class=\"sr-th-krow\">Reading the images<\/p>\n<h2>What this scan shows<\/h2>\n<p>Thyroid tissue is the easiest parenchyma in the neck to read, because normal is so uniform. At 10 MHz the gland fills with fine, even speckle, a little brighter than the strap muscles lying over it, and anything that interrupts that evenness is worth a second look. Most of what interrupts it is not a nodule.<\/p>\n<figure class=\"sr-th-fig\">\n<img src=\"https:\/\/suresultmed.com\/wp-content\/uploads\/thyroid-gland-vessel-fascial-shadow.jpg\" alt=\"Frozen transverse neck image on a Suresult D3Ultra showing uniform thyroid tissue, a large anechoic vessel in cross-section and a darker band of fascial shadowing beside it, 40 mm depth, H10.0 MHz, compound imaging off\" width=\"1300\" height=\"905\" loading=\"lazy\" decoding=\"async\"><figcaption class=\"sr-th-figcap\"><b>Uniform gland, one vessel, one artefact, frozen at 5:36.<\/b> The round anechoic structure is a vessel in cross-section. The dark band running down beside it is not a cleft in the gland: fascia above it is blocking the beam, so less sound comes back from that column and it draws darker than it should. Linear array &middot; Thyroid preset &middot; D 40 mm &middot; F H10.0 MHz &middot; GN 86 dB &middot; DR 60 &middot; Compound OFF.<\/figcaption><\/figure>\n<p>Both of those interruptions are in the frame above. A round black structure inside or beside the gland could be a nodule and is usually a vessel: slide along it and the vessel keeps going while a nodule ends, and colour or power Doppler settles the argument in a second. The dark column next to it is fascial shadowing, and it is the finding I see mistaken for a real defect most often. Neither one gets scored.<\/p>\n<p>What does get scored is a discrete focus with edges &mdash; and the moment you find one, the measurement convention starts to matter. The ACR system defines taller-than-wide on the transverse image, with the height measured parallel to the beam and the width perpendicular to it. So the 4 mm anterior-to-posterior dimension here is the height, and the 5 mm superior-to-inferior one is not a candidate for it at all. That is why a nodule whose largest single number is 5 mm is still wider than tall and scores nothing for shape. Read the plane wrong and you have invented three points and moved a benign nodule two levels up the chart.<\/p>\n<\/section>\n<section id=\"transcript\">\n<p class=\"sr-th-krow\">Verbatim<\/p>\n<h2>Full transcript<\/h2>\n<details class=\"sr-th-tx\" id=\"sr-th-transcript\" data-sr-transcript=\"1\" open>\n<summary>Transcript &mdash; 13:45, 20 passages<\/summary>\n<div class=\"sr-th-txbody\">\n<p class=\"sr-th-txnote\"><span>Transcribed from the recording and edited for readability; square brackets mark an editorial clarification. Every timestamp jumps the video, and the first of them opens the player where the walkthrough begins.<\/span><\/p>\n<section class=\"sr-th-txsec\">\n<h3 class=\"sr-th-txwin\">Why this scan, and on whom<\/h3>\n<div class=\"sr-th-txcol\">\n<p class=\"sr-th-txp\"><a class=\"sr-th-txt\" href=\"#t=11\" data-sr-seek=\"11\">0:00<\/a>Hello. Today we\u2019re going to use a Suresult D3Ultra handheld ultrasound to investigate the thyroid gland, looking for nodules. Nodules are very common \u2014 most people have nodules. They\u2019re normally benign, but not always. So we\u2019re actually going to do this on myself. Typically I use my wife as the sample patient for these videos, but her thyroid is boring \u2014 it\u2019s normal. I have a thyroid nodule. So not only are we going to scan and find it, and take measurements, but we\u2019re going to see: should I worry about this, and do I need an aspiration or not? And I\u2019ll cover the requirements and the guidelines as to what to do when you\u2019re looking for nodules, and whether follow-ups are necessary and whether aspiration is necessary.<\/p>\n<p class=\"sr-th-txp\"><a class=\"sr-th-txt\" href=\"#t=48\" data-sr-seek=\"48\">0:48<\/a>In terms of patient positioning, typically the patient is supine on an examination bed or table and the sonographer or the doctor is standing next to them, or sitting next to them. But there\u2019s a little bit of a problem with that position. It\u2019s fine \u2014 you have good access to the thyroid gland \u2014 but you have to be careful with your arm. I\u2019ve heard of complaints, particularly from female patients, that the sonographer or the doctor molested them. You can imagine: if you\u2019re here, where does your arm rest? The doctor\u2019s arm is going to rest on the breast. So be very careful with your positioning. I like actually the sitting position, so I\u2019ll place the patient in a chair and I\u2019ll stand behind them. I can have the screen in front of both the patient and myself, so we\u2019re both looking at the screen together, and that\u2019s a very comfortable position to scan from. The other position that works very well is the patient face up, so supine, again \u2014 this works well with a chiropractic table where there\u2019s space at the top of the table. So I sit behind them, and it\u2019s very similar to the seated position. And again, there\u2019s no way I can accidentally brush up against someone\u2019s breast from that position.<\/p>\n<\/div>\n<\/section>\n<section class=\"sr-th-txsec\">\n<h3 class=\"sr-th-txwin\">Probe, frequency and what a bedside study documents<\/h3>\n<div class=\"sr-th-txcol\">\n<p class=\"sr-th-txp\"><a class=\"sr-th-txt\" href=\"#t=123\" data-sr-seek=\"123\">2:03<\/a>Now, the thyroid is a relatively shallow structure, so we\u2019re going to be using the linear side of the transducer. You want to use a relatively high frequency, something in between maybe 10 to 15 megahertz, for checking out the thyroid. If you haven\u2019t evaluated the thyroid before, a lot of people think it\u2019s higher than it is, because the thyroid cartilage is way up here but the thyroid gland is much, much lower. So just keep that in mind.<\/p>\n<p class=\"sr-th-txp\"><a class=\"sr-th-txt\" href=\"#t=155\" data-sr-seek=\"155\">2:35<\/a>And let\u2019s talk protocols and documentation just for a moment. As a point-of-care practitioner, I often have a clinical question in mind and I\u2019m just scanning to answer that clinical question. These series of videos are: I have one question, I\u2019m going to scan it just enough so that I can answer that one clinical question. Sonographers, particularly the technicians, might just be taking pictures to send to a radiologist who will then evaluate the pictures, so they have a list of pictures that they need to take. Whereas for myself, particularly if it\u2019s normal, I might just take a couple of images just to prove that I did scan it, but I\u2019m not necessarily following a protocol. I don\u2019t have a set number of pictures I need to take, and on different days and for different people I take different pictures, because I might have different clinical questions. The typical protocol for a sonographer is: they might come in sagittal, measure the dimensions lengthwise and take a picture; they go in a transverse plane, again they measure the dimensions and take a picture; take a picture superior, take a picture inferior, screen through, done. But for us, particularly for this video, I don\u2019t care about the dimensions of the thyroid. I am looking for nodules. If I find a nodule, then I\u2019m going to take measurements of that nodule. I don\u2019t really care about the overall size of the thyroid, because that isn\u2019t my clinical question today.<\/p>\n<p class=\"sr-th-txp\"><a class=\"sr-th-txt\" href=\"#t=232\" data-sr-seek=\"232\">3:52<\/a>And a general rule of thumb is to screen through structures in two planes. Basically you could screen through in this direction and screen through in this direction. And then if anything looks wrong \u2014 if I see a nodule \u2014 that\u2019s where I go in both planes and I take measurements of the nodule. And we need those measurements of the nodule to determine whether we need follow-up, whether this might be malignant or not.<\/p>\n<\/div>\n<\/section>\n<section class=\"sr-th-txsec\">\n<h3 class=\"sr-th-txwin\">The gland on screen<\/h3>\n<div class=\"sr-th-txcol\">\n<p class=\"sr-th-txp\"><a class=\"sr-th-txt\" href=\"#t=260\" data-sr-seek=\"260\">4:20<\/a>Okay, so let\u2019s scan my thyroid. As I mentioned, I should have a nodule somewhere, so let\u2019s find it and evaluate it. I just need some gel on the unit here. Should be plenty. And let\u2019s see what we see. Okay. There\u2019s a few things to talk about already. So what are we looking at? This here is our thyroid gland, and that is an artery.<\/p>\n<p class=\"sr-th-txp\"><a class=\"sr-th-txt\" href=\"#t=296\" data-sr-seek=\"296\">4:56<\/a>Now, to identify the vessels: a nodule is going to appear and disappear as you screen through it, because it\u2019s small, or it\u2019s round or oblong \u2014 it has a finite size. Blood vessels will continue; you can follow it up, up, up, and you can follow it down, down, down. The other thing you can do is you can turn on colour Doppler or power Doppler, and of course the blood vessels are going to pulse because they have fluid in them, whereas you don\u2019t expect that pulsatile flow through the entire nodule. So that\u2019s another way to distinguish a blood vessel from a nodule.<\/p>\n<p class=\"sr-th-txp\"><a class=\"sr-th-txt\" href=\"#t=332\" data-sr-seek=\"332\">5:32<\/a>The other thing you\u2019ll notice is the sort of edge effects here, sometimes called refraction artifacts, here with the blood vessel. We also have a bit of a shadowing artifact here. So my thyroid gland doesn\u2019t actually have a shadowed section within it. This isn\u2019t a cleft; it isn\u2019t cut in two. What\u2019s happened is that because of all this fascial tissue right here, this is preventing some of the sound beams coming this way from going into this region. So fewer sound beams from this area are reaching back to the transducer, and so the area appears darker than it should be. So this is an imaging artifact. This is nice and uniform thyroid tissue. This is normal thyroid tissue.<\/p>\n<p class=\"sr-th-txp\"><a class=\"sr-th-txt\" href=\"#t=378\" data-sr-seek=\"378\">6:18<\/a>Now if you want, you can turn on \u2014 I have just normal B-mode on \u2014 so you can even try compound imaging if you don\u2019t like this speckled appearance. It\u2019ll smooth things out, but at the cost of some frame rate. And there are different types of compound imaging; I believe this is frequency compounding instead of spatial. Spatial compound imaging can sometimes prevent some of that fascial shadowing artifact from appearing. So this is compound imaging on, and I can turn it back off. I prefer it off unless I\u2019m taking a really nice-looking picture; if I want a nice-looking picture I\u2019ll turn compound imaging on, because sometimes it gives you better-looking pictures.<\/p>\n<\/div>\n<\/section>\n<section class=\"sr-th-txsec\">\n<h3 class=\"sr-th-txwin\">Finding the nodule, and measuring it<\/h3>\n<div class=\"sr-th-txcol\">\n<p class=\"sr-th-txp\"><a class=\"sr-th-txt\" href=\"#t=422\" data-sr-seek=\"422\">7:02<\/a>So let\u2019s find that nodule. I can screen all the way up to the top and I can follow it down, and I get a little bit of that artifact. Oh, what the heck is that? A dark circle appears and winks in and out of existence. That\u2019s not normal. Let\u2019s finish screening \u2014 screen all the way down, all the way down, all the way down. And there\u2019s nothing else funny going on, just that one tiny nodule.<\/p>\n<p class=\"sr-th-txp\"><a class=\"sr-th-txt\" href=\"#t=455\" data-sr-seek=\"455\">7:35<\/a>Okay, so let\u2019s go to that nodule. So it\u2019s sometimes difficult to get that perfect picture, but remember you can record cine clips with the software here. I can just swipe left and right and I can go through the individual frames, so I can try to find the best frame for taking measurements. And we want the largest measurements, so maybe that would give us the best measurements. So I can at least get two measurements here \u2014 some lengths \u2014 and a lot of the guidelines, you want the largest measurements. So 4 millimetres there. I can get another length here, and also 4 millimetres. So it\u2019s 4 millimetres by 4 millimetres so far.<\/p>\n<p class=\"sr-th-txp\"><a class=\"sr-th-txt\" href=\"#t=513\" data-sr-seek=\"513\">8:33<\/a>And we have to of course go in the other axis and see what it is in that axis. So I can save this image, and then I\u2019m going to go in the other axis. Here we go. And you can screen through in this axis, see if there\u2019s anything strange. And right away you can see where that nodule is. Maybe that\u2019s the best picture of it there. Let\u2019s take a measurement of that. So it\u2019s about five. So it\u2019s four by four by five. So not that big.<\/p>\n<\/div>\n<\/section>\n<section class=\"sr-th-txsec\">\n<h3 class=\"sr-th-txwin\">Scoring it<\/h3>\n<div class=\"sr-th-txcol\">\n<p class=\"sr-th-txp\"><a class=\"sr-th-txt\" href=\"#t=553\" data-sr-seek=\"553\">9:13<\/a>So, do I have cancer? Is my thyroid nodule an issue? If you remember, the dimensions were 4 by 4 by 5 in terms of millimetres, so less than 1 centimetre large. You\u2019ll learn if it\u2019s less than 1 centimetre large, it\u2019s probably not malignant.<\/p>\n<p class=\"sr-th-txp\"><a class=\"sr-th-txt\" href=\"#t=573\" data-sr-seek=\"573\">9:33<\/a>But there are guidelines, for example from the American College of Radiology. They have the TI-RADS chart, and you basically give points for the composition, the echogenicity, the shape, the margin, and whether there are echogenic foci. And you give points, and depending on how many points \u2014 you know, whether you need to follow up and monitor, because it\u2019s a little suspicious, moderately suspicious, highly suspicious \u2014 whether you need an aspiration or not. Again, whether you need an aspiration: it\u2019s how suspicious is it, and how big is it.<\/p>\n<p class=\"sr-th-txp\"><a class=\"sr-th-txt\" href=\"#t=609\" data-sr-seek=\"609\">10:09<\/a>So let\u2019s quickly use my nodule as an example. Composition: cystic, or almost completely cystic, or spongiform \u2014 so it looks like a sponge \u2014 both those are zero points. So even if you have a nodule and it\u2019s spongiform, that can be perfectly normal, probably benign. In fact there\u2019s a special condition here that if it\u2019s spongiform, if it looks like a sponge, don\u2019t even bother calculating other points for other categories: it\u2019s benign. So, mixed cystic and solid; solid and almost completely solid \u2014 mine was cystic, so zero points.<\/p>\n<p class=\"sr-th-txp\"><a class=\"sr-th-txt\" href=\"#t=645\" data-sr-seek=\"645\">10:45<\/a>Echogenicity: mine was black, mine was anechoic \u2014 zero points. Shape: wider than tall, or taller than wide. Now what they mean by tall is the anterior-to-posterior distance, and mine was 4 millimetres; the 5-millimetre measurement was superior to inferior. So mine is wider than tall, so it\u2019s not tall \u2014 the tall isn\u2019t the largest dimension. So zero points. So so far I\u2019m zero, zero, zero. Margin: in one plane it looks smooth; in the other plane it has a little bit of irregularity to it, just a little bit. Maybe it\u2019s ill-defined \u2014 so maybe I would call this ill-defined at worst. Zero points. So so far I\u2019m zero, zero, zero, zero. Echogenic foci: are there microcalcifications, peripheral calcifications, comet-tail artifacts? We didn\u2019t see any of this stuff, so zero points. So: zero points. Benign. Don\u2019t worry about it.<\/p>\n<p class=\"sr-th-txp\"><a class=\"sr-th-txt\" href=\"#t=705\" data-sr-seek=\"705\">11:45<\/a>And if you want this chart, or a chart like this, there\u2019s many charts like this online. And of course you can look up the original paper from the American College of Radiology. Or, for example, here\u2019s a calculator \u2014 you just put it in and it tells you. It also summarizes some of the information for you from the research paper that created the TI-RADS classification, like how many points and what\u2019s the risk of malignancy.<\/p>\n<\/div>\n<\/section>\n<section class=\"sr-th-txsec\">\n<h3 class=\"sr-th-txwin\">Follow-up, and closing<\/h3>\n<div class=\"sr-th-txcol\">\n<p class=\"sr-th-txp\"><a class=\"sr-th-txt\" href=\"#t=735\" data-sr-seek=\"735\">12:15<\/a>Now, in terms of follow-ups: if it is getting worse \u2014 I know it says follow up at one, three, five years \u2014 if you follow up at one year and yeah, it jumped from a TI-RADS score of 3 to 4, don\u2019t wait two years to follow up again. If it\u2019s getting worse, follow up at least once a year, if it seems to be getting worse. I\u2019ve actually seen a very large nodule, almost 3 centimetres I think in size, and I followed up a year later and it was gone. I couldn\u2019t believe it. She couldn\u2019t believe it; she\u2019s like, you\u2019re making a mistake. It\u2019s like, no, it\u2019s not there, I trust myself. So these things can get worse and they can actually get better.<\/p>\n<p class=\"sr-th-txp\"><a class=\"sr-th-txt\" href=\"#t=783\" data-sr-seek=\"783\">13:03<\/a>But it\u2019s just as easy as that. The thyroid is one of the easiest things to check, and just following the TI-RADS chart is super easy. And I think if you have any suspicions and you have an ultrasound unit, why not check it out?<\/p>\n<p class=\"sr-th-txp\"><a class=\"sr-th-txt\" href=\"#t=800\" data-sr-seek=\"800\">13:20<\/a>[Sponsor segment omitted, 13:20\u201313:45]<\/p>\n<\/div>\n<\/section>\n<\/div>\n<\/details>\n<\/section>\n<section id=\"device\" class=\"sr-choice\">\n<p class=\"sr-th-krow\">Hardware<\/p>\n<h2>Device and settings<\/h2>\n<p>One head, one preset, one set of numbers for the whole gland. The left column below is the published specification; the right is what the panel actually showed while this scan was running. Read the two together and one thing stands out. This array is the linear side of a three-geometry head and it tops out at 10 MHz, while Ramakko names 10 to 15 MHz as the band he wants for a thyroid &mdash; so the scan is being run at the floor of his own recommendation, and it still resolves a 4 mm anechoic focus cleanly enough to measure twice. That is the honest read of a multi-geometry probe on small parts: sufficient rather than optimal. <strong>A three-geometry head is not a good fit if thyroid, nerve and other small-parts work is most of your week: a dedicated high-frequency linear probe will out-resolve this one, and I would buy that instead.<\/strong> If the same head has to reach a kidney, a heart and a fetus in the same clinic day, the trade runs the other way and this is the probe I would carry.<\/p>\n<figure class=\"sr-th-fig\">\n<img src=\"https:\/\/suresultmed.com\/wp-content\/uploads\/thyroid-compound-imaging-on-d3ultra.jpg\" alt=\"Live transverse thyroid image on a Suresult D3Ultra with compound imaging switched on, the parameter column reading Compound ON at 40 mm depth and H10.0 MHz\" width=\"1300\" height=\"905\" loading=\"lazy\" decoding=\"async\"><figcaption class=\"sr-th-figcap\"><b>Compound imaging on, live, at 6:40.<\/b> The parameter column reads Compound: ON and the speckle smooths out; frame rate pays for it. It goes back off inside the same minute, which is the right call while you are still sweeping for something small. Linear array &middot; D 40 mm &middot; F H10.0 MHz &middot; GN 86 dB &middot; Compound ON.<\/figcaption><\/figure>\n<div class=\"sr-th-dev\">\n<div class=\"sr-th-dev__grid\">\n<div class=\"sr-th-dev__col\" data-sr-spec-table=\"1\">\n<p class=\"sr-th-dev__h\">Published specification<\/p>\n<p class=\"sr-th-dev__name\">Suresult D3Ultra<\/p>\n<p class=\"sr-th-dev__price\">Three geometries, one head &mdash; {{SRX_PRICE:28571}}<\/p>\n<ul class=\"sr-th-spec\">\n<li><b>Linear<\/b><span>7.5\/10 MHz &middot; 20\/40\/60\/100 mm &middot; 40 mm<\/span><\/li>\n<li><b>Convex<\/b><span>3.2\/5.0 MHz &middot; 90&ndash;300 mm &middot; 45&deg;<\/span><\/li>\n<li><b>Phased<\/b><span>3.2\/5.0 MHz &middot; 90&ndash;300 mm &middot; 60&deg;<\/span><\/li>\n<li><b>Modes<\/b><span>B, M, Color, Power, PW Doppler<\/span><\/li>\n<li><b>Channels<\/b><span>192 elements &middot; 64 channels &middot; 256 greys<\/span><\/li>\n<li><b>Ranges<\/b><span>Gain 30&ndash;105 dB &middot; dynamic range 40&ndash;110<\/span><\/li>\n<li><b>Handset<\/b><span>263 g &middot; 156&times;65&times;20 mm &middot; 2 h<\/span><\/li>\n<li><b>Connects<\/b><span>iOS, Android, Windows &middot; dual-band Wi-Fi<\/span><\/li>\n<\/ul>\n<\/div>\n<div class=\"sr-th-dev__col\">\n<p class=\"sr-th-dev__h\">What the panel actually showed<\/p>\n<ul class=\"sr-th-spec\">\n<li><b>Head<\/b><span>Linear side &middot; unchanged for the whole scan<\/span><\/li>\n<li><b>Preset<\/b><span>Thyroid<\/span><\/li>\n<li><b>Depth<\/b><span>D 40 mm &middot; never adjusted on camera<\/span><\/li>\n<li><b>Frequency<\/b><span>F H10.0 MHz, harmonic &middot; the ceiling of this array<\/span><\/li>\n<li><b>Gain<\/b><span>GN 86 dB &middot; two thirds of the published range<\/span><\/li>\n<li><b>Dynamic range<\/b><span>DR 60 &middot; ENH 0<\/span><\/li>\n<li><b>Processing<\/b><span>Compound OFF &middot; on briefly at 6:18, then off<\/span><\/li>\n<li><b>Output<\/b><span>MI 0.9 &middot; TIS 0.2<\/span><\/li>\n<li><b>Software<\/b><span>V 3.6.78 &middot; cine buffer stepped through at 7:35<\/span><\/li>\n<li><b>Mode<\/b><span>B throughout &middot; Doppler is described, never switched on<\/span><\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div class=\"sr-th-dev__links\"><a href=\"https:\/\/suresultmed.com\/shop\/handheld-ultrasounds\/d3ultra-multipurpose-handheld-ultrasound\/\">D3Ultra specification and price &rarr;<\/a><a href=\"https:\/\/suresultmed.com\/specialty\/handheld-ultrasound-for-endocrinology\/\">Endocrinology hub &rarr;<\/a><a href=\"https:\/\/suresultmed.com\/suresult-video-library\/\">Scan Library &rarr;<\/a><\/div>\n<\/div>\n<\/section>\n<section id=\"related\">\n<p class=\"sr-th-krow\">Same head, other windows<\/p>\n<h2>Related scans<\/h2>\n<div class=\"sr-th-rels\"><a class=\"sr-th-rel\" href=\"https:\/\/suresultmed.com\/carpal-tunnel-ultrasound-median-nerve\/\"><span class=\"sr-th-rel__img\"><img decoding=\"async\" src=\"https:\/\/suresultmed.com\/wp-content\/uploads\/carpal-tunnel-median-nerve-anisotropy-poster.jpg\" alt=\"Transverse wrist scan on a handheld linear probe showing the flexor tendons and the median nerve among them\" width=\"640\" height=\"360\" loading=\"lazy\"><span class=\"sr-th-rel__len\">5:27<\/span><\/span><span class=\"sr-th-rel__b\"><span class=\"sr-th-rel__t\">Median nerve at the wrist, measured<\/span><span class=\"sr-th-rel__d\">The other small-parts study this array is built for: separate the nerve from the tendons by tilting, then take its cross-sectional area.<\/span><span class=\"sr-th-rel__cta\">Read the walkthrough &rarr;<\/span><\/span><\/a><a class=\"sr-th-rel\" href=\"https:\/\/suresultmed.com\/efast-exam-handheld-ultrasound\/\"><span class=\"sr-th-rel__img\"><img decoding=\"async\" src=\"https:\/\/suresultmed.com\/wp-content\/uploads\/efast-exam-right-upper-quadrant-poster.jpg\" alt=\"Right upper quadrant scan on a handheld probe: liver and right kidney with the hepatorenal recess between them\" width=\"640\" height=\"360\" loading=\"lazy\"><span class=\"sr-th-rel__len\">14:09<\/span><\/span><span class=\"sr-th-rel__b\"><span class=\"sr-th-rel__t\">eFAST: the whole trauma survey<\/span><span class=\"sr-th-rel__d\">The long one. Pericardium, both upper quadrants and the pelvis in a single pass, on the curved and phased sides of the same head.<\/span><span class=\"sr-th-rel__cta\">Read the walkthrough &rarr;<\/span><\/span><\/a><a class=\"sr-th-rel\" href=\"https:\/\/suresultmed.com\/b-lines-lung-ultrasound-blue-protocol\/\"><span class=\"sr-th-rel__img\"><img decoding=\"async\" src=\"https:\/\/suresultmed.com\/wp-content\/uploads\/lung-ultrasound-pleural-line-m-mode-poster.jpg\" alt=\"Lung ultrasound frame on a handheld probe: bright pleural line in B-mode with an M-mode strip below it\" width=\"640\" height=\"360\" loading=\"lazy\"><span class=\"sr-th-rel__len\">9:28<\/span><\/span><span class=\"sr-th-rel__b\"><span class=\"sr-th-rel__t\">Lungs: A-lines, B-lines and the BLUE protocol<\/span><span class=\"sr-th-rel__d\">Sliding, A-lines, B-lines and the curtain sign, four points a side, with the M-mode strip that settles a pneumothorax.<\/span><span class=\"sr-th-rel__cta\">Read the walkthrough &rarr;<\/span><\/span><\/a><a class=\"sr-th-rel\" href=\"https:\/\/suresultmed.com\/rib-fracture-ultrasound-pocus\/\"><span class=\"sr-th-rel__img\"><img decoding=\"async\" src=\"https:\/\/suresultmed.com\/wp-content\/uploads\/rib-short-axis-cortex-shadow-poster.jpg\" alt=\"Short-axis rib view on a handheld linear probe: rib cross-sections with acoustic shadowing beneath them\" width=\"640\" height=\"360\" loading=\"lazy\"><span class=\"sr-th-rel__len\">6:42<\/span><\/span><span class=\"sr-th-rel__b\"><span class=\"sr-th-rel__t\">Rib cortex, followed to the cartilage<\/span><span class=\"sr-th-rel__d\">Bone at the top of the linear range: an unbroken bright rail, the step that breaks it, and the junction that only looks like one.<\/span><span class=\"sr-th-rel__cta\">Read the walkthrough &rarr;<\/span><\/span><\/a><\/div>\n<p class=\"sr-th-hublink\">The rest of the recordings, filed by anatomy and by the probe they were shot on, sit in the <a href=\"https:\/\/suresultmed.com\/suresult-video-library\/\">Scan Library<\/a>.<\/p>\n<\/section>\n<section id=\"faq\">\n<p class=\"sr-th-krow\">Asked on this search<\/p>\n<h2>Thyroid nodule questions<\/h2>\n<div class=\"sr-faq sr-th-faq\">\n<details class=\"sr-th-q\" open>\n<summary>What does a thyroid nodule look like on ultrasound?<\/summary>\n<p>A nodule is a discrete focus inside otherwise uniform gland, and the giveaway is that it begins and ends. Sweep through the lobe and it appears, grows, shrinks and disappears, because it is a finite object. Its appearance is then described in five ways, which is exactly what the ACR system scores: what it is made of, how bright it is against the parenchyma around it, whether it is taller than it is wide, what its edge does, and whether it contains bright specks. The one in this recording is anechoic, smooth and wider than tall, which is the benign end of every one of those five scales. I would train on that appearance before hunting for the suspicious version of it, because the whole system is calibrated against normal.<\/p>\n<p><span class=\"sr-th-cite\">Source: <a href=\"https:\/\/edge.sitecorecloud.io\/americancoldf5f-acrorgf92a-productioncb02-3650\/media\/ACR\/Files\/RADS\/TI-RADS\/TI-RADS-Assessment-Categories.pdf\" rel=\"nofollow noopener\" target=\"_blank\">ACR TI-RADS assessment categories (American College of Radiology, chart)<\/a>. Accessed September 10, 2026.<\/span><\/details>\n<details class=\"sr-th-q\">\n<summary>How big does a thyroid nodule have to be before it gets biopsied?<\/summary>\n<p>Size alone never decides it. The ACR system pairs each risk level with its own size threshold: a mildly suspicious nodule is sampled at 2.5 cm and followed at 1.5 cm, a moderately suspicious one is sampled at 1.5 cm and followed at 1 cm, and a highly suspicious one is sampled at 1 cm and followed at 0.5 cm. Below those numbers the published recommendation is no biopsy and no imaging follow-up at all. Nothing scored benign or not suspicious is biopsied at any size. That is why the 4 by 4 by 5 mm nodule measured here needs neither: at 5 mm it sits under every biopsy threshold in the system.<\/p>\n<p><span class=\"sr-th-cite\">Source: <a href=\"https:\/\/edge.sitecorecloud.io\/americancoldf5f-acrorgf92a-productioncb02-3650\/media\/ACR\/Files\/RADS\/TI-RADS\/TI-RADS-Assessment-Categories.pdf\" rel=\"nofollow noopener\" target=\"_blank\">ACR TI-RADS assessment categories (American College of Radiology, chart)<\/a>. Accessed September 10, 2026.<\/span><\/details>\n<details class=\"sr-th-q\">\n<summary>Can ultrasound tell if a thyroid nodule is cancerous?<\/summary>\n<p>It cannot make the diagnosis, and it is not meant to. What it does is stratify risk well enough to decide who gets a needle, which is the stated purpose of the ACR system: thyroid nodules are extremely common and most turn out benign, so the scoring exists to stop the ones that will prove benign from being biopsied. Five sonographic features are scored, the points are added, and the total maps to one of five levels from benign to highly suspicious, each with its own biopsy and follow-up size. Cytology from a fine-needle aspiration is what confirms or excludes malignancy.<\/p>\n<p><span class=\"sr-th-cite\">Source: <a href=\"https:\/\/www.acr.org\/Clinical-Resources\/Clinical-Tools-and-Reference\/Reporting-and-Data-Systems\/TI-RADS\" rel=\"nofollow noopener\" target=\"_blank\">ACR Thyroid Imaging Reporting and Data System (TI-RADS), American College of Radiology<\/a>. Accessed September 10, 2026.<\/span><\/details>\n<details class=\"sr-th-q\">\n<summary>How do you tell a thyroid nodule from a blood vessel on ultrasound?<\/summary>\n<p>Follow it. A vessel keeps going as you slide the probe along the neck, up and down, while a nodule has ends and disappears within a few millimetres of travel. If that is not conclusive, put colour or power Doppler on it: the vessel fills and pulses, and a small nodule does not fill the same way. Both manoeuvres are demonstrated in the walkthrough at 4:56. A third giveaway is on the same frames, and it is the one that catches people out: the dark band running down through the gland beside the vessel is edge and fascial shadowing, not a cleft and not a lesion.<\/p>\n<p><span class=\"sr-th-cite\">Read off the device panel and demonstrated by Brandon Ramakko, DC in the recording above.<\/span><\/details>\n<details class=\"sr-th-q\">\n<summary>What ultrasound settings do you use for a thyroid scan?<\/summary>\n<p>Shallow and high frequency, because the gland sits about a centimetre under the skin. The device in this recording ran its linear array on the thyroid preset at 40 mm depth and 10 MHz harmonic, gain 86 dB, dynamic range 60, compound imaging off, in B mode throughout, and none of that changed for the whole scan. The presenter names 10 to 15 MHz as the band he wants, so this array is sitting at the bottom of it. Compound imaging is worth knowing about but not worth leaving on: it smooths the speckle and costs frame rate, which is the wrong trade while you are still sweeping for something.<\/p>\n<p><span class=\"sr-th-cite\">Read off the device panel and demonstrated by Brandon Ramakko, DC in the recording above.<\/span><\/details>\n<\/div>\n<\/section>\n<section id=\"sources\">\n<p class=\"sr-th-krow\">Provenance<\/p>\n<h2>Sources<\/h2>\n<ul class=\"sr-th-src\">\n<li><a href=\"https:\/\/edge.sitecorecloud.io\/americancoldf5f-acrorgf92a-productioncb02-3650\/media\/ACR\/Files\/RADS\/TI-RADS\/TI-RADS-Assessment-Categories.pdf\" rel=\"nofollow noopener\" target=\"_blank\">ACR TI-RADS assessment categories (American College of Radiology, chart)<\/a><span>The primary chart. Five feature categories with their point values, the five levels from TR1 to TR5, and the biopsy and follow-up size threshold attached to each level. Also the measurement convention for taller-than-wide, and the spongiform exception. Accessed September 10, 2026.<\/span><\/li>\n<li><a href=\"https:\/\/www.acr.org\/Clinical-Resources\/Clinical-Tools-and-Reference\/Reporting-and-Data-Systems\/TI-RADS\" rel=\"nofollow noopener\" target=\"_blank\">ACR Thyroid Imaging Reporting and Data System (TI-RADS), American College of Radiology<\/a><span>The programme page: the lexicon, the risk-stratification system, and the stated purpose of it, which is to identify which nodules warrant biopsy and spare the rest. Accessed September 10, 2026.<\/span><\/li>\n<li><a href=\"https:\/\/doi.org\/10.1016\/j.jacr.2017.01.046\" rel=\"nofollow noopener\" target=\"_blank\">Tessler FN, Middleton WD, Grant EG, Hoang JK, Berland LL, Teefey SA, et al. ACR Thyroid Imaging, Reporting and Data System (TI-RADS): White Paper of the ACR TI-RADS Committee. Journal of the American College of Radiology 2017;14(5):587\u2013595<\/a><span>The paper behind the chart, and the one the presenter points at when he says to look up the original. Accessed September 10, 2026.<\/span><\/li>\n<li><a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC4739132\/\" rel=\"nofollow noopener\" target=\"_blank\">Haugen BR, Alexander EK, Bible KC, Doherty GM, et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid 2016;26(1):1\u2013133<\/a><span>The management guideline that sits around the imaging: who is worked up, when cytology is indicated, and what happens after it. Accessed September 10, 2026.<\/span><\/li>\n<li><a href=\"https:\/\/radssupport.acr.org\/support\/solutions\/articles\/11000071474-acr-ti-rads-faq\" rel=\"nofollow noopener\" target=\"_blank\">ACR TI-RADS frequently asked questions (American College of Radiology)<\/a><span>Committee answers on applying the system in practice, including how the categories are assigned when a feature cannot be determined. Accessed September 10, 2026.<\/span><\/li>\n<li><a href=\"https:\/\/suresultmed.com\/shop\/handheld-ultrasounds\/d3ultra-multipurpose-handheld-ultrasound\/\" rel=\"nofollow noopener\" target=\"_blank\">D3Ultra product page (Suresult)<\/a><span>Frequency, depth and gain ranges for the linear array run throughout this scan. Accessed September 10, 2026.<\/span><\/li>\n<li><a href=\"https:\/\/www.youtube.com\/watch?v=RtwRj6zDpWo\" rel=\"nofollow noopener\" target=\"_blank\">POCUS Thyroid Nodule Evaluation \u2014 Suresult channel, 12 October 2025<\/a><span>Brandon Ramakko, DC scans and narrates; every timestamp above points into it. Accessed September 10, 2026.<\/span><\/li>\n<\/ul>\n<\/section>\n<div class=\"sr-final-cta\">\n<div>\n<h2>Which probe does your neck work actually need?<\/h2>\n<p>Small parts want frequency and almost no depth. Abdomen and cardiac want the opposite, and no single head is best at both. Tell us what actually walks through your door in a week and you will get a straight recommendation in one conversation &mdash; the three-in-one head, a dedicated linear probe, or nothing yet.<\/p>\n<\/div>\n<div class=\"sr-chat-link\">\n<button class=\"sr-crisp-consult-btn\" type=\"button\" data-sr-crisp-open onclick=\"window.$crisp=window.$crisp||[];window.$crisp.push(['do','chat:open']);\">ONLINE EXPERT CONSULT<\/button>\n<\/div>\n<\/div>\n<nav id=\"sr-th-toc\" class=\"sr-light-toc sr-sticky-toc sr-article-toc\" data-suresult-toc data-sr-hide-on-wide-table aria-label=\"Thyroid walkthrough navigation\">\n<div class=\"sr-light-toc__head\">\n<div class=\"sr-light-toc__title\">On this page<\/div>\n<p><span class=\"sr-light-toc__progress\" id=\"sr-th-progress\">0%<\/span><\/div>\n<div class=\"sr-light-toc__links\"><a href=\"#quick-answer\">Quick answer<\/a><a href=\"#scorecard\">The scorecard<\/a><a href=\"#key-moments\">Key moments<\/a><a href=\"#what-it-shows\">What it shows<\/a><a href=\"#transcript\">Transcript<\/a><a href=\"#device\">Device<\/a><a href=\"#related\">Related scans<\/a><a href=\"#faq\">Questions<\/a><a href=\"#sources\">Sources<\/a><\/div>\n<p class=\"sr-light-toc__note\">Not sure which probe your neck work needs?<\/p>\n<p><button class=\"sr-crisp-consult-btn\" type=\"button\" data-sr-crisp-open onclick=\"window.$crisp=window.$crisp||[];window.$crisp.push(['do','chat:open']);\">ONLINE EXPERT CONSULT<\/button><br \/>\n<\/nav>\n<\/div>\n<p><script>(function(){\nvar AMP=String.fromCharCode(38);\nvar VID='RtwRj6zDpWo';\nfunction embed(start){\nvar u='https:\/\/www.youtube-nocookie.com\/embed\/'+VID+'?rel=0'+AMP+'autoplay=1';\nif(start){u=u+AMP+'start='+start;}\nreturn u;\n}\nfunction mount(start){\nvar pl=document.getElementById('sr-th-player');\nif(!pl){return null;}\nif(pl.classList.contains('is-live')){\nvar fr=pl.querySelector('iframe');\nif(fr){fr.src=embed(start);}\nreturn pl;\n}\nvar f=document.createElement('iframe');\nf.src=embed(start);\nf.title='Thyroid nodule ultrasound: the scan, the measurement and the score';\nf.allow='accelerometer;autoplay;clipboard-write;encrypted-media;gyroscope;picture-in-picture';\nf.setAttribute('allowfullscreen','');\npl.innerHTML='';\npl.appendChild(f);\npl.classList.add('is-live');\nreturn pl;\n}\nvar p0=document.getElementById('sr-th-player');\nif(p0){p0.addEventListener('click',function(){mount(11);});}\nvar tx=document.getElementById('sr-th-transcript');\nif(tx){\nif(window.matchMedia('(max-width:768px)').matches){tx.removeAttribute('open');}\n}\ndocument.addEventListener('click',function(e){\nvar t0=e.target;\nif(!t0){return;}\nif(!t0.closest){return;}\nvar a=t0.closest('[data-sr-seek]');\nif(!a){return;}\ne.preventDefault();\nvar pl=mount(a.getAttribute('data-sr-seek'));\nif(pl){pl.scrollIntoView({behavior:'smooth',block:'start'});}\n});\nvar toc=document.getElementById('sr-th-toc');\nif(toc){\nvar links=[].slice.call(toc.querySelectorAll('a[href^=\"#\"]'));\nvar secs=[];\nvar map={};\nlinks.forEach(function(a){\nvar id=a.getAttribute('href').slice(1);\nvar el=document.getElementById(id);\nif(el){secs.push(el);map[id]=a;}\n});\nwindow.__srBlSpy=function(){\nif(!links.length){return;}\nvar line=window.innerHeight*0.28;\nvar idx=0;\nfor(var i=0;i<secs.length;i++){\nif(secs[i].getBoundingClientRect().top<=line){idx=i;}\n}\nlinks.forEach(function(l){l.classList.remove('sr-toc-active');});\nlinks[idx].classList.add('sr-toc-active');\n};\nif(window.IntersectionObserver){\nvar io=new IntersectionObserver(function(){window.__srBlSpy();},{rootMargin:'-12% 0px -72% 0px'});\nsecs.forEach(function(s){io.observe(s);});\n}\nwindow.__srBlSpy();\n}\nvar pr=document.getElementById('sr-th-progress');\nvar tick=false;\nfunction upd(){\ntick=false;\nif(window.__srBlSpy){window.__srBlSpy();}\nvar h=document.documentElement;\nvar m=h.scrollHeight-h.clientHeight;\nvar v=m>0?Math.round(h.scrollTop\/m*100):0;\nif(pr){pr.textContent=v+'%';}\n}\nwindow.addEventListener('scroll',function(){\nif(tick){return;}\ntick=true;\nrequestAnimationFrame(upd);\n},{passive:true});\nupd();\n})();<\/script><br \/>\n<script type=\"application\/ld+json\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/suresultmed.com\/thyroid-nodule-ultrasound-scan\/#article\",\"headline\":\"Thyroid Nodule Ultrasound: Find It, Measure It, Score It on TI-RADS\",\"description\":\"A thyroid survey run end to end on a linear array: screening both lobes in two planes, separating a nodule from a vessel and a shadow artefact from a cleft, measuring the nodule in three axes off the cine buffer, and scoring it against the five ACR TI-RADS feature categories \u2014 with timestamped key moments, the full transcript, and the depth, gain and frequency read off the device panel.\",\"datePublished\":\"2026-09-10\",\"dateModified\":\"2026-09-10\",\"inLanguage\":\"en-US\",\"mainEntityOfPage\":{\"@type\":\"WebPage\",\"@id\":\"https:\/\/suresultmed.com\/thyroid-nodule-ultrasound-scan\/\"},\"image\":\"https:\/\/suresultmed.com\/wp-content\/uploads\/thyroid-nodule-ultrasound-scan-cover.jpg\",\"author\":[{\"@type\":\"Person\",\"@id\":\"https:\/\/suresultmed.com\/#fernando-mariz-md\",\"name\":\"Fernando Mariz, MD\",\"jobTitle\":\"Gynecology and pelvic surgery physician\",\"url\":\"https:\/\/suresultmed.com\/author\/dr-fernando-mariz-md\/\",\"knowsAbout\":[\"Gynecology\",\"Pelvic surgery\",\"Sonography\",\"Point-of-care ultrasound\"]},{\"@type\":\"Person\",\"@id\":\"https:\/\/suresultmed.com\/#jailyn-avila-md\",\"name\":\"Jailyn Avila, MD\",\"jobTitle\":\"Emergency medicine physician and POCUS educator\",\"knowsAbout\":[\"Emergency medicine\",\"Point-of-care ultrasound\",\"Residency education\"]}],\"publisher\":{\"@type\":\"Organization\",\"@id\":\"https:\/\/suresultmed.com\/#organization\",\"name\":\"Suresult\",\"url\":\"https:\/\/suresultmed.com\/\"},\"video\":{\"@id\":\"https:\/\/suresultmed.com\/thyroid-nodule-ultrasound-scan\/#video\"},\"about\":{\"@type\":\"MedicalTest\",\"name\":\"Thyroid nodule ultrasound (thyroid POCUS)\"},\"keywords\":\"thyroid nodule ultrasound, thyroid nodule ultrasound images, thyroid ultrasound, tirads ultrasound, ACR TI-RADS, thyroid nodule measurement, thyroid POCUS\"},{\"@type\":\"VideoObject\",\"@id\":\"https:\/\/suresultmed.com\/thyroid-nodule-ultrasound-scan\/#video\",\"name\":\"POCUS thyroid nodule evaluation \u2014 a full scan, measure and TI-RADS walkthrough with transcript\",\"description\":\"A thyroid scan on a linear array at 10 MHz: screening the lobe in two planes, distinguishing a nodule from a vessel by following it and by Doppler, reading edge and fascial shadowing as artefact rather than pathology, measuring a small nodule in three axes off the cine buffer, and scoring it live against composition, echogenicity, shape, margin and echogenic foci.\",\"thumbnailUrl\":[\"https:\/\/suresultmed.com\/wp-content\/uploads\/thyroid-nodule-transverse-gland-poster.jpg\"],\"uploadDate\":\"2025-10-12\",\"duration\":\"PT13M45S\",\"embedUrl\":\"https:\/\/www.youtube-nocookie.com\/embed\/RtwRj6zDpWo?start=11\",\"startOffset\":11,\"isFamilyFriendly\":true,\"inLanguage\":\"en\",\"publisher\":{\"@type\":\"Organization\",\"@id\":\"https:\/\/suresultmed.com\/#organization\",\"name\":\"Suresult\",\"url\":\"https:\/\/suresultmed.com\/\"},\"actor\":{\"@type\":\"Person\",\"@id\":\"https:\/\/suresultmed.com\/thyroid-nodule-ultrasound-scan\/#presenter\",\"name\":\"Brandon Ramakko\",\"honorificSuffix\":\"DC\",\"description\":\"The clinician who performs and narrates the scan in the recording on this page.\"},\"mainEntityOfPage\":{\"@id\":\"https:\/\/suresultmed.com\/thyroid-nodule-ultrasound-scan\/\"},\"transcript\":\"Hello. Today we\u2019re going to use a Suresult D3Ultra handheld ultrasound to investigate the thyroid gland, looking for nodules. Nodules are very common \u2014 most people have nodules. They\u2019re normally benign, but not always. So we\u2019re actually going to do this on myself. Typically I use my wife as the sample patient for these videos, but her thyroid is boring \u2014 it\u2019s normal. I have a thyroid nodule. So not only are we going to scan and find it, and take measurements, but we\u2019re going to see: should I worry about this, and do I need an aspiration or not? And I\u2019ll cover the requirements and the guidelines as to what to do when you\u2019re looking for nodules, and whether follow-ups are necessary and whether aspiration is necessary. In terms of patient positioning, typically the patient is supine on an examination bed or table and the sonographer or the doctor is standing next to them, or sitting next to them. But there\u2019s a little bit of a problem with that position. It\u2019s fine \u2014 you have good access to the thyroid gland \u2014 but you have to be careful with your arm. I\u2019ve heard of complaints, particularly from female patients, that the sonographer or the doctor molested them. You can imagine: if you\u2019re here, where does your arm rest? The doctor\u2019s arm is going to rest on the breast. So be very careful with your positioning. I like actually the sitting position, so I\u2019ll place the patient in a chair and I\u2019ll stand behind them. I can have the screen in front of both the patient and myself, so we\u2019re both looking at the screen together, and that\u2019s a very comfortable position to scan from. The other position that works very well is the patient face up, so supine, again \u2014 this works well with a chiropractic table where there\u2019s space at the top of the table. So I sit behind them, and it\u2019s very similar to the seated position. And again, there\u2019s no way I can accidentally brush up against someone\u2019s breast from that position. Now, the thyroid is a relatively shallow structure, so we\u2019re going to be using the linear side of the transducer. You want to use a relatively high frequency, something in between maybe 10 to 15 megahertz, for checking out the thyroid. If you haven\u2019t evaluated the thyroid before, a lot of people think it\u2019s higher than it is, because the thyroid cartilage is way up here but the thyroid gland is much, much lower. So just keep that in mind. And let\u2019s talk protocols and documentation just for a moment. As a point-of-care practitioner, I often have a clinical question in mind and I\u2019m just scanning to answer that clinical question. These series of videos are: I have one question, I\u2019m going to scan it just enough so that I can answer that one clinical question. Sonographers, particularly the technicians, might just be taking pictures to send to a radiologist who will then evaluate the pictures, so they have a list of pictures that they need to take. Whereas for myself, particularly if it\u2019s normal, I might just take a couple of images just to prove that I did scan it, but I\u2019m not necessarily following a protocol. I don\u2019t have a set number of pictures I need to take, and on different days and for different people I take different pictures, because I might have different clinical questions. The typical protocol for a sonographer is: they might come in sagittal, measure the dimensions lengthwise and take a picture; they go in a transverse plane, again they measure the dimensions and take a picture; take a picture superior, take a picture inferior, screen through, done. But for us, particularly for this video, I don\u2019t care about the dimensions of the thyroid. I am looking for nodules. If I find a nodule, then I\u2019m going to take measurements of that nodule. I don\u2019t really care about the overall size of the thyroid, because that isn\u2019t my clinical question today. And a general rule of thumb is to screen through structures in two planes. Basically you could screen through in this direction and screen through in this direction. And then if anything looks wrong \u2014 if I see a nodule \u2014 that\u2019s where I go in both planes and I take measurements of the nodule. And we need those measurements of the nodule to determine whether we need follow-up, whether this might be malignant or not. Okay, so let\u2019s scan my thyroid. As I mentioned, I should have a nodule somewhere, so let\u2019s find it and evaluate it. I just need some gel on the unit here. Should be plenty. And let\u2019s see what we see. Okay. There\u2019s a few things to talk about already. So what are we looking at? This here is our thyroid gland, and that is an artery. Now, to identify the vessels: a nodule is going to appear and disappear as you screen through it, because it\u2019s small, or it\u2019s round or oblong \u2014 it has a finite size. Blood vessels will continue; you can follow it up, up, up, and you can follow it down, down, down. The other thing you can do is you can turn on colour Doppler or power Doppler, and of course the blood vessels are going to pulse because they have fluid in them, whereas you don\u2019t expect that pulsatile flow through the entire nodule. So that\u2019s another way to distinguish a blood vessel from a nodule. The other thing you\u2019ll notice is the sort of edge effects here, sometimes called refraction artifacts, here with the blood vessel. We also have a bit of a shadowing artifact here. So my thyroid gland doesn\u2019t actually have a shadowed section within it. This isn\u2019t a cleft; it isn\u2019t cut in two. What\u2019s happened is that because of all this fascial tissue right here, this is preventing some of the sound beams coming this way from going into this region. So fewer sound beams from this area are reaching back to the transducer, and so the area appears darker than it should be. So this is an imaging artifact. This is nice and uniform thyroid tissue. This is normal thyroid tissue. Now if you want, you can turn on \u2014 I have just normal B-mode on \u2014 so you can even try compound imaging if you don\u2019t like this speckled appearance. It\u2019ll smooth things out, but at the cost of some frame rate. And there are different types of compound imaging; I believe this is frequency compounding instead of spatial. Spatial compound imaging can sometimes prevent some of that fascial shadowing artifact from appearing. So this is compound imaging on, and I can turn it back off. I prefer it off unless I\u2019m taking a really nice-looking picture; if I want a nice-looking picture I\u2019ll turn compound imaging on, because sometimes it gives you better-looking pictures. So let\u2019s find that nodule. I can screen all the way up to the top and I can follow it down, and I get a little bit of that artifact. Oh, what the heck is that? A dark circle appears and winks in and out of existence. That\u2019s not normal. Let\u2019s finish screening \u2014 screen all the way down, all the way down, all the way down. And there\u2019s nothing else funny going on, just that one tiny nodule. Okay, so let\u2019s go to that nodule. So it\u2019s sometimes difficult to get that perfect picture, but remember you can record cine clips with the software here. I can just swipe left and right and I can go through the individual frames, so I can try to find the best frame for taking measurements. And we want the largest measurements, so maybe that would give us the best measurements. So I can at least get two measurements here \u2014 some lengths \u2014 and a lot of the guidelines, you want the largest measurements. So 4 millimetres there. I can get another length here, and also 4 millimetres. So it\u2019s 4 millimetres by 4 millimetres so far. And we have to of course go in the other axis and see what it is in that axis. So I can save this image, and then I\u2019m going to go in the other axis. Here we go. And you can screen through in this axis, see if there\u2019s anything strange. And right away you can see where that nodule is. Maybe that\u2019s the best picture of it there. Let\u2019s take a measurement of that. So it\u2019s about five. So it\u2019s four by four by five. So not that big. So, do I have cancer? Is my thyroid nodule an issue? If you remember, the dimensions were 4 by 4 by 5 in terms of millimetres, so less than 1 centimetre large. You\u2019ll learn if it\u2019s less than 1 centimetre large, it\u2019s probably not malignant. But there are guidelines, for example from the American College of Radiology. They have the TI-RADS chart, and you basically give points for the composition, the echogenicity, the shape, the margin, and whether there are echogenic foci. And you give points, and depending on how many points \u2014 you know, whether you need to follow up and monitor, because it\u2019s a little suspicious, moderately suspicious, highly suspicious \u2014 whether you need an aspiration or not. Again, whether you need an aspiration: it\u2019s how suspicious is it, and how big is it. So let\u2019s quickly use my nodule as an example. Composition: cystic, or almost completely cystic, or spongiform \u2014 so it looks like a sponge \u2014 both those are zero points. So even if you have a nodule and it\u2019s spongiform, that can be perfectly normal, probably benign. In fact there\u2019s a special condition here that if it\u2019s spongiform, if it looks like a sponge, don\u2019t even bother calculating other points for other categories: it\u2019s benign. So, mixed cystic and solid; solid and almost completely solid \u2014 mine was cystic, so zero points. Echogenicity: mine was black, mine was anechoic \u2014 zero points. Shape: wider than tall, or taller than wide. Now what they mean by tall is the anterior-to-posterior distance, and mine was 4 millimetres; the 5-millimetre measurement was superior to inferior. So mine is wider than tall, so it\u2019s not tall \u2014 the tall isn\u2019t the largest dimension. So zero points. So so far I\u2019m zero, zero, zero. Margin: in one plane it looks smooth; in the other plane it has a little bit of irregularity to it, just a little bit. Maybe it\u2019s ill-defined \u2014 so maybe I would call this ill-defined at worst. Zero points. So so far I\u2019m zero, zero, zero, zero. Echogenic foci: are there microcalcifications, peripheral calcifications, comet-tail artifacts? We didn\u2019t see any of this stuff, so zero points. So: zero points. Benign. Don\u2019t worry about it. And if you want this chart, or a chart like this, there\u2019s many charts like this online. And of course you can look up the original paper from the American College of Radiology. Or, for example, here\u2019s a calculator \u2014 you just put it in and it tells you. It also summarizes some of the information for you from the research paper that created the TI-RADS classification, like how many points and what\u2019s the risk of malignancy. Now, in terms of follow-ups: if it is getting worse \u2014 I know it says follow up at one, three, five years \u2014 if you follow up at one year and yeah, it jumped from a TI-RADS score of 3 to 4, don\u2019t wait two years to follow up again. If it\u2019s getting worse, follow up at least once a year, if it seems to be getting worse. I\u2019ve actually seen a very large nodule, almost 3 centimetres I think in size, and I followed up a year later and it was gone. I couldn\u2019t believe it. She couldn\u2019t believe it; she\u2019s like, you\u2019re making a mistake. It\u2019s like, no, it\u2019s not there, I trust myself. So these things can get worse and they can actually get better. But it\u2019s just as easy as that. The thyroid is one of the easiest things to check, and just following the TI-RADS chart is super easy. And I think if you have any suspicions and you have an ultrasound unit, why not check it out? [Sponsor segment omitted, 13:20\u201313:45]\",\"hasPart\":[{\"@type\":\"Clip\",\"@id\":\"https:\/\/suresultmed.com\/thyroid-nodule-ultrasound-scan\/#clip-11\",\"name\":\"Why scan a thyroid, and whose nodule this is\",\"startOffset\":11,\"endOffset\":48,\"url\":\"https:\/\/suresultmed.com\/thyroid-nodule-ultrasound-scan\/#t=11\"},{\"@type\":\"Clip\",\"@id\":\"https:\/\/suresultmed.com\/thyroid-nodule-ultrasound-scan\/#clip-48\",\"name\":\"Positioning the patient, and where your arm ends up\",\"startOffset\":48,\"endOffset\":123,\"url\":\"https:\/\/suresultmed.com\/thyroid-nodule-ultrasound-scan\/#t=48\"},{\"@type\":\"Clip\",\"@id\":\"https:\/\/suresultmed.com\/thyroid-nodule-ultrasound-scan\/#clip-123\",\"name\":\"The linear side, and the frequency band he asks for\",\"startOffset\":123,\"endOffset\":155,\"url\":\"https:\/\/suresultmed.com\/thyroid-nodule-ultrasound-scan\/#t=123\"},{\"@type\":\"Clip\",\"@id\":\"https:\/\/suresultmed.com\/thyroid-nodule-ultrasound-scan\/#clip-155\",\"name\":\"What a point-of-care study documents, and screening in two planes\",\"startOffset\":155,\"endOffset\":260,\"url\":\"https:\/\/suresultmed.com\/thyroid-nodule-ultrasound-scan\/#t=155\"},{\"@type\":\"Clip\",\"@id\":\"https:\/\/suresultmed.com\/thyroid-nodule-ultrasound-scan\/#clip-260\",\"name\":\"First look: uniform gland, and the artery beside it\",\"startOffset\":260,\"endOffset\":296,\"url\":\"https:\/\/suresultmed.com\/thyroid-nodule-ultrasound-scan\/#t=260\"},{\"@type\":\"Clip\",\"@id\":\"https:\/\/suresultmed.com\/thyroid-nodule-ultrasound-scan\/#clip-296\",\"name\":\"Vessel or nodule: follow it through, then reach for Doppler\",\"startOffset\":296,\"endOffset\":332,\"url\":\"https:\/\/suresultmed.com\/thyroid-nodule-ultrasound-scan\/#t=296\"},{\"@type\":\"Clip\",\"@id\":\"https:\/\/suresultmed.com\/thyroid-nodule-ultrasound-scan\/#clip-332\",\"name\":\"A dark band that is an artefact, not a cleft in the gland\",\"startOffset\":332,\"endOffset\":378,\"url\":\"https:\/\/suresultmed.com\/thyroid-nodule-ultrasound-scan\/#t=332\"},{\"@type\":\"Clip\",\"@id\":\"https:\/\/suresultmed.com\/thyroid-nodule-ultrasound-scan\/#clip-378\",\"name\":\"Compound imaging switched on, then straight back off\",\"startOffset\":378,\"endOffset\":422,\"url\":\"https:\/\/suresultmed.com\/thyroid-nodule-ultrasound-scan\/#t=378\"},{\"@type\":\"Clip\",\"@id\":\"https:\/\/suresultmed.com\/thyroid-nodule-ultrasound-scan\/#clip-422\",\"name\":\"Screening the whole lobe, and the circle that winks in and out\",\"startOffset\":422,\"endOffset\":455,\"url\":\"https:\/\/suresultmed.com\/thyroid-nodule-ultrasound-scan\/#t=422\"},{\"@type\":\"Clip\",\"@id\":\"https:\/\/suresultmed.com\/thyroid-nodule-ultrasound-scan\/#clip-455\",\"name\":\"Cine review, then the first two lengths\",\"startOffset\":455,\"endOffset\":513,\"url\":\"https:\/\/suresultmed.com\/thyroid-nodule-ultrasound-scan\/#t=455\"},{\"@type\":\"Clip\",\"@id\":\"https:\/\/suresultmed.com\/thyroid-nodule-ultrasound-scan\/#clip-513\",\"name\":\"The second axis, and the size verdict\",\"startOffset\":513,\"endOffset\":573,\"url\":\"https:\/\/suresultmed.com\/thyroid-nodule-ultrasound-scan\/#t=513\"},{\"@type\":\"Clip\",\"@id\":\"https:\/\/suresultmed.com\/thyroid-nodule-ultrasound-scan\/#clip-573\",\"name\":\"ACR TI-RADS, scored live: five categories, five zeroes\",\"startOffset\":573,\"endOffset\":705,\"url\":\"https:\/\/suresultmed.com\/thyroid-nodule-ultrasound-scan\/#t=573\"},{\"@type\":\"Clip\",\"@id\":\"https:\/\/suresultmed.com\/thyroid-nodule-ultrasound-scan\/#clip-735\",\"name\":\"Follow-up in practice, and one nodule that went away\",\"startOffset\":735,\"endOffset\":783,\"url\":\"https:\/\/suresultmed.com\/thyroid-nodule-ultrasound-scan\/#t=735\"}]},{\"@type\":\"FAQPage\",\"@id\":\"https:\/\/suresultmed.com\/thyroid-nodule-ultrasound-scan\/#faq\",\"mainEntity\":[{\"@type\":\"Question\",\"name\":\"What does a thyroid nodule look like on ultrasound?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"A nodule is a discrete focus inside otherwise uniform gland, and the giveaway is that it begins and ends. Sweep through the lobe and it appears, grows, shrinks and disappears, because it is a finite object. Its appearance is then described in five ways, which is exactly what the ACR system scores: what it is made of, how bright it is against the parenchyma around it, whether it is taller than it is wide, what its edge does, and whether it contains bright specks. The one in this recording is anechoic, smooth and wider than tall, which is the benign end of every one of those five scales. I would train on that appearance before hunting for the suspicious version of it, because the whole system is calibrated against normal.\"}},{\"@type\":\"Question\",\"name\":\"How big does a thyroid nodule have to be before it gets biopsied?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Size alone never decides it. The ACR system pairs each risk level with its own size threshold: a mildly suspicious nodule is sampled at 2.5 cm and followed at 1.5 cm, a moderately suspicious one is sampled at 1.5 cm and followed at 1 cm, and a highly suspicious one is sampled at 1 cm and followed at 0.5 cm. Below those numbers the published recommendation is no biopsy and no imaging follow-up at all. Nothing scored benign or not suspicious is biopsied at any size. That is why the 4 by 4 by 5 mm nodule measured here needs neither: at 5 mm it sits under every biopsy threshold in the system.\"}},{\"@type\":\"Question\",\"name\":\"Can ultrasound tell if a thyroid nodule is cancerous?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"It cannot make the diagnosis, and it is not meant to. What it does is stratify risk well enough to decide who gets a needle, which is the stated purpose of the ACR system: thyroid nodules are extremely common and most turn out benign, so the scoring exists to stop the ones that will prove benign from being biopsied. Five sonographic features are scored, the points are added, and the total maps to one of five levels from benign to highly suspicious, each with its own biopsy and follow-up size. Cytology from a fine-needle aspiration is what confirms or excludes malignancy.\"}},{\"@type\":\"Question\",\"name\":\"How do you tell a thyroid nodule from a blood vessel on ultrasound?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Follow it. A vessel keeps going as you slide the probe along the neck, up and down, while a nodule has ends and disappears within a few millimetres of travel. If that is not conclusive, put colour or power Doppler on it: the vessel fills and pulses, and a small nodule does not fill the same way. Both manoeuvres are demonstrated in the walkthrough at 4:56. A third giveaway is on the same frames, and it is the one that catches people out: the dark band running down through the gland beside the vessel is edge and fascial shadowing, not a cleft and not a lesion.\"}},{\"@type\":\"Question\",\"name\":\"What ultrasound settings do you use for a thyroid scan?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Shallow and high frequency, because the gland sits about a centimetre under the skin. The device in this recording ran its linear array on the thyroid preset at 40 mm depth and 10 MHz harmonic, gain 86 dB, dynamic range 60, compound imaging off, in B mode throughout, and none of that changed for the whole scan. The presenter names 10 to 15 MHz as the band he wants, so this array is sitting at the bottom of it. Compound imaging is worth knowing about but not worth leaving on: it smooths the speckle and costs frame rate, which is the wrong trade while you are still sweeping for something.\"}}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/suresultmed.com\/thyroid-nodule-ultrasound-scan\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/suresultmed.com\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Scan Library\",\"item\":\"https:\/\/suresultmed.com\/suresult-video-library\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Thyroid nodule ultrasound: the scan, the measurement and the score\",\"item\":\"https:\/\/suresultmed.com\/thyroid-nodule-ultrasound-scan\/\"}]}]}<\/script><\/p>\n","protected":false},"excerpt":{"rendered":"<p>A thyroid run end to end on the linear side of a three-in-one head &mdash; sweep the lobe in two<\/p>","protected":false},"author":1,"featured_media":35938,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_seopress_titles_title":"Thyroid Nodule Ultrasound: Measure It and Score TI-RADS","_seopress_titles_desc":"Screen the gland in two planes, tell a nodule from a vessel, measure it in three axes and read the score \u2014 timestamped, with the full transcript.","_seopress_robots_index":"","_seopress_robots_follow":"","_seopress_robots_imageindex":"","_seopress_robots_snippet":"","_seopress_robots_primary_cat":"","_seopress_robots_breadcrumbs":"","_seopress_robots_freeze_modified_date":"","_seopress_robots_custom_modified_date":"","_seopress_robots_canonical":"","_seopress_social_fb_title":"","_seopress_social_fb_desc":"","_seopress_social_fb_img":"https:\/\/suresultmed.com\/wp-content\/uploads\/thyroid-nodule-ultrasound-scan-cover.jpg","_seopress_social_fb_img_attachment_id":35938,"_seopress_social_fb_img_width":1600,"_seopress_social_fb_img_height":900,"_seopress_social_twitter_title":"","_seopress_social_twitter_desc":"","_seopress_social_twitter_img":"https:\/\/suresultmed.com\/wp-content\/uploads\/thyroid-nodule-ultrasound-scan-cover.jpg","_seopress_social_twitter_img_attachment_id":35938,"_seopress_social_twitter_img_width":1600,"_seopress_social_twitter_img_height":900,"_seopress_redirections_value":"","_seopress_redirections_enabled":"","_seopress_redirections_enabled_regex":"","_seopress_redirections_logged_status":"","_seopress_redirections_param":"","_seopress_redirections_type":0,"_seopress_analysis_target_kw":"","_seopress_news_disabled":"","_seopress_video_disabled":"","_seopress_video":[],"_seopress_pro_schemas_manual":[],"_seopress_pro_rich_snippets_disable_all":"","_seopress_pro_rich_snippets_disable":[],"_seopress_pro_schemas":[],"footnotes":""},"categories":[457],"tags":[],"class_list":["post-35937","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-scan-library"],"acf":[],"_links":{"self":[{"href":"https:\/\/suresultmed.com\/ja\/wp-json\/wp\/v2\/posts\/35937","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/suresultmed.com\/ja\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/suresultmed.com\/ja\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/suresultmed.com\/ja\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/suresultmed.com\/ja\/wp-json\/wp\/v2\/comments?post=35937"}],"version-history":[{"count":6,"href":"https:\/\/suresultmed.com\/ja\/wp-json\/wp\/v2\/posts\/35937\/revisions"}],"predecessor-version":[{"id":36019,"href":"https:\/\/suresultmed.com\/ja\/wp-json\/wp\/v2\/posts\/35937\/revisions\/36019"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/suresultmed.com\/ja\/wp-json\/wp\/v2\/media\/35938"}],"wp:attachment":[{"href":"https:\/\/suresultmed.com\/ja\/wp-json\/wp\/v2\/media?parent=35937"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/suresultmed.com\/ja\/wp-json\/wp\/v2\/categories?post=35937"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/suresultmed.com\/ja\/wp-json\/wp\/v2\/tags?post=35937"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}