1. THYROID ULTRASOUND – SONOGRAPHER WORKSHEET
Patient Name: __________________
Patient MRN: __________________
(Your Hospital Logo)
THYROID ULTRASOUND – SONOGRAPHER WORKSHEET
Current Date: __________ Comparison Date: __________ Age: ________ Sex: F M
RT : ___ x ___ x ___ mm ( ___ mL) Isth: ___ mm
LT : ___ x ___ x ___ mm ( ___ mL)
Parenchyma: Homogeneous or Coarse
Contour: Smooth or Nodular
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LEFT
Notes
INDEX NODULE #1
Size: ____ (AP) x ____ (trv) x ____ (CC) mm
Size:
AP < Trv
AP > Trv
Composition:
Mostly Cystic
Spongiform
Cystic & Solid
Mostly Solid
Echogenicity:
Anechoic
Hyperechoic
Isoechoic
Hypoechoic
Very hypoechoic
Margin:
Smooth
Ill-defined
Lobulated
Irregular
Extra-thyroid
extension
Echogenic Foci:
None
Comet-tail
Ca2+ shadowing
Ca2+ rim/periph
Punctate
echogenic foci
RIGHT
LEFT 2b 3 4 5 1 6 7 2a 2b 3 4 5 1 6 7 2a
Add’l Thyroid Nodules or Lymph Nodes Features
#2: ____ x ____ x ____mm
#3: ____ x ____ x ____mm
#4: ____ x ____ x ____mm