Thyroid sonography permits the determination of the size, localization and the structure of the thyroid gland, thyroid nodules and adjacent structures. The value of this procedure depends not only on the experience of the investigators but also on the quality of their written reports. We thus compared, on an intra-individual basis, thyroid sonographic investigations from 325 patients reported by 180 general radiologists (134 different radiological offices) with those subsequently done in our own thyroid outpatient department. 172 of 325 reports (53%) reported the thyroid’s size in general terms (e.g. „enlarged“), but only 18 (5%) actually stated volume and dimensions. Only 87 (27%) reports documented the size of both lobes in 3 dimensions or the volume. 117 (37%) reports contained no information about the overall echostructure. The presence of thyroid nodules was correctly stated in 258 (79%) patients. However, 129 (50%) reports did not contain the localisation of the observed nodule and 33 (20%) reports did not provide information on their echostructure, an important information concerning risk of malignancy. In 175 (68%), 50 (19%) and in 14 (5%) reports the exact size of the largest nodule was given in 1, 2 or 3 dimensions, respectively. The latter is, however, a prerequiste to calculate the nodules’ precise size, since thyroid nodules are mostly ovoid (e.g. the 258 dominant nodules of this study were 1.3 by 1.5 by 1.9cm [median, p<0.0001] in size). This report pattern was independent of the nodule size. A sketch of the sonogram, which would be the most useful form of documentation, was not provided in a single case. Taken together these results clearly show the limited value of written sonographic reports obtained by patients/general practitioners prior to their visit to a specialized thyroid outpatient department, lacking the information necessary to decide whether to simply follow up or whether additional, diagnostic procedures such a scintigraphy or fine needle aspiration biopsy are required.
