US Thyroid - Microcalcification must be distinguished from the inspissated colloid that may also appear as tiny echogenic foci. In contradistinction to microcalcification, the presence of colloid is a reliable indicator of benignity. High-frequency US will demonstrate comet-tail or ring-down artifact with colloid, which is not seen with microcalcification.

Thyroid nodules: When to biopsy

US Thyroid - Colloid Cyst - Longitudinal ultrasound shows the typical appearance of a colloid nodule with multiple “comet tail” artifacts  scattered throughout the cyst. Note the thin walls and posterior acoustic enhancement

Thyroid - Colloid Cyst - Longitudinal ultrasound shows the typical appearance of a colloid nodule with multiple “comet tail” artifacts scattered throughout the cyst. Note the thin walls and posterior acoustic enhancement

US Thyroid - Papillary carcinoma - Occasionally demonstrates a cystic component and may mimic a benign nodule, though the presence of punctate calcification within the solid component helps in its identification.

US Thyroid - Papillary carcinoma - Occasionally demonstrates a cystic component and may mimic a benign nodule, though the presence of punctate calcification within the solid component helps in its identification.

US Thyroid - Coarse Nodule Calcification -  dense shadowing within a thyroid nodule suggestive of benign calcification - Coarse, dysmorphic or curvilinear calcifications commonly indicate benignity.

US Thyroid - Coarse Nodule Calcification - dense shadowing within a thyroid nodule suggestive of benign calcification - Coarse, dysmorphic or curvilinear calcifications commonly indicate benignity.

Thyroid - Vascularity of nodules

Thyroid - Vascularity of nodules

Thyroid - Minimal thyroid volume

Thyroid - Minimal thyroid volume

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