Figure 2

Thyroid ultrasound with contrast enhancement and biopsy. Longitudinal view of the right lobe of the thyroid gland performed with linear probe (7.5-14 Mhz) in conventional ultrasound (panel A, D) and after contrast enhancement ultrasound (panel B,C). Panel A shows a hypoechoic lesion of the right lobe of the thyroid gland. The yellow arrow indicates a metastatic lymph node located close to the upper pole of the right lobe. Panel B shows the hypovascular aspect of the nodule and lymph node after contrast injection. The enhancement is located only in the peripheral part both of nodule and lymph node as well. Panel C shows the enhancement in the venous phase which is still located only in the peripheral part of the nodule, except for the presence of small tiny vessels located also in the central part. Panel D show the path of the needle inserted inside of the nodule.