U l t r a s o u n d     c r i t e r i a     of     g o i t e r.
(Goiter is a pathologic enlargement of the thyroid gland)
Sex - F. Age - 55. Weight - 61 kg. Height - 159 cm. cm.

T h y r o i d    g l a n d

Anatomical structure of the thyroid gland and larynx.
Thyroid gland has two lobes connected by the isthmus.
Larynx has an intermediate type of structure.
Thyroid cartilage angle is 90 degrees.
Position is changed.
Upper poles mount to the middle of the thyroid cartilage superior horns.
Lower poles mount to the 10th-11th tracheal cartilages.
Upper border of the isthmus mounts to the cricothyroid ligament.
Shape is deformed.
Anterior surface is protruded and antedisplaced.
Lateral border is straightened and displaced to outside.
Posterior surface is protruded and displaced towards vertibri.
Medial border is displaced to the sagittal line and repeats the shape of the trachea.

S i z e     is     i n c r e a s e d
Height of the thyroid lobe - 125 mm. Width - 111 mm.
Depth - 50 mm. Depth of the isthmus - 26 mm.
Volume of the thyroid gland (according to the tomographic findings) - 200,4 cm3
Echostructure is microgranular, homogenous.

Integrated
optical density -
0.4919±0.2006
 
S u r r o u n d i n g   o r g a n s   and   t i s s u e s

Trachea.
Is deformed and narrowed proportionally in depth and width .
Length of narrowing in height - 75 mm.
Maximum narrowing in width - 18 mm.
Maximum narrowing in depth - 14 mm.
Level of maximum narrowing - 35 mm from the cricotracheal ligament.
Total narrowing of the trachea lumen - 72%.
Esophagus.

Is deformed and narrowed proportionally in depth and width .
Length of narrowing in height - 55 mm.
Maximum narrowing in width - 13 mm.
Maximum narrowing in depth - 4 mm.
Level of maximum narrowing - 35 mm from the cricotracheal ligament.
Total narrowing of the esophagus lumen - 50%.
Muscles of the neck.
Anterior group of muscles
- sternothyroid and sternohyoid muscles.They are very thinned.
Total depth - 3 mm. Total thinning - 70%.
Posterior group of muscles
- long muscle of the head, long muscle of the neck,
anterior scalene muscle, middle scalene muscle, posterior scalene muscle.
They are thinned and retrodisplaced.
Fascia cervicalis is condensed.
Greater vessels of the neck - the common carotid artery and internal jugular vein are
displaced from the sagittal line to outside and backwards.
 



Fig.38.1. Large goiter. Echograms of the thyroid gland and their shematic representations. Scale 1:2. Fig.38.1 in-cludes sections No.4, 7, 11, 14, 18, 21. The section number is given in the top right corner of the schematic representa-tion.







Fig.38.2. Lagre goiter. Reconstructed two-dimensional images of the thyroid gland. A - Right lateral view - projection on the sagittal plane. B - Anterior view - projection on the frontal plane. Scale 1:1. Horizontal lines in fig.38.2.B show the levels of transverse section. Numbers in rectangular frame indicate the sections included in fig.38.1. Signs. 1 - mus-culus constrictor pharyngis inferior, 2 - cartilago thyroidea, 3 - cartilago cricoidea, 4 - glandula thyroidea, lobus dexter, 5 - oesophagus, 6 - vertebra, 7 - trachea, 8 - sagittal line.