embroidered dress blue Navy HATSUNE MIKU EXPO 10th Color:Tea Rose nav-12

embroidered dress blue Navy HATSUNE MIKU EXPO 10th Color:Tea Rose nav-12

HATSUNE MIKU EXPO 10th Anniversary

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Color:Tea Rose

• Increase in echogenicity due to the presence of Tg within the lymph node • Microcalcifications • Mixed or peripherial flow • Cystic in advanced disease Lymph Node Doppler: • Hilar: flow branches radially from the hilum • Peripheral: flow is present along the periphery of the node but does not arise from the hilar vessels • Mixed: hilar and peripheral flow • Absence of flow despite optimal Doppler settings • Literature is inconsistent on benefit of color and pulsed Doppler Zone 6 Abnormalities: • Following thyroidectomy, the paratracheal region should be homogeneous • Z6 masses can include: • Postoperative scarring • Muscle • Necrosing fat • Suture granulomas • Parathyroid gland • Lymph node • Remnant tissue • Metastasis Zone 1: • Medial or anterior to the SMG • Midline/superior to hyoid bone • Nodal group: submental/submandibular • Unusual to have papillary involvement in Zone 1 • Often see reactive nodes Zone 6: • Anterior/medial to the CCA • From the hyoid inferiorly to the manubrium • Nodal group: anterior cervical nodes, pre and para tracheal • 20% of recurrences are in Zone 6 Zone 2: • Lateral/posterior to the SMG • Superior to the hyoid bone (CCA bifurcation) • Nodal group: upper IJ chain, parotid nodes • Reactive nodes can be seen in Zone 2 • Uncommon for PTC, but can occur Zone 3: • From the level of the hyoid (CCA bifurcation) to the cricoid cartilage (level of expected thyroid bed) • Lateral to CCA • Nodal group: middle IJ chain • 60-75% of recurrences are in Zone 3 or 4 Zone 4: • From the cricoid arch to the level of the clavicle (thyroid bed level) • Lateral to the CCA • Nodal group: lower IJ chain • 60-75% of recurrences are in Zone 3 or 4 Zone 7/Notch: • Anterior/ medial to CCA • At or inferior to the sternal notch • Nodal group: anterior, upper mediastinal nodes • Zone 7 vs Notch: • Zone 7 is inferior to the subclavian • This changes surgical management