甲状腺中心|Your Visit
Appointments at the Thyroid Center can be scheduled by calling 617-355-8226. Plan to arrive 15 minutes before your scheduled visit time. A complete visit lasts approximately two hours.
Arrival and check-in
- When you arrive, you will be asked to complete a questionnaire about your child’s symptoms and medical history. A clinical assistant will measure your child’s height, weight, heart rate, and blood pressure.
- Next, you and your child will meet with a Thyroid Center nurse, who will review medical information and answer any questions you may have about the clinic.
- In most cases, the nurse will place a topical anesthetic cream on the front of your child’s neck. This cream helps to numb the area in case a fine-needle aspiration biopsy is recommended when you see the physician. This numbing cream takes about 30 minutes to work.
- While the numbing cream starts working, the nurse will give you directions to your thyroid ultrasound appointment. A Thyroid Center endocrinologist will meet you in the Thyroid Ultrasound Clinic, which is located across the street at neighboring Brigham and Women’s Hospital.
Thyroid ultrasound
- In the Thyroid Ultrasound Clinic, you and your child will meet a Thyroid Center endocrinologist who will review your child’s medical history and perform a physical examination.
- One of our expert radiologists will perform a complete ultrasound evaluation of the thyroid gland and neck. Ultrasound is a safe and painless method of imaging, and is the best way to evaluate the size and characteristics of a thyroid nodule.
- 在用放射科医生审查成像结果后，您的内分泌学家将与您讨论结果，并提出关于下一步的建议，包括是否建议使用细针吸气（活检）。一些常见的方案包括：
- No significant thyroid nodules are found, and no further imaging or testing is needed.
- One or more thyroid nodules is found, but no fine-needle aspiration is necessary now. However, another ultrasound or blood tests may be needed in the future to make sure nothing changes.
- One or more thyroid nodules is found, and a fine-needle aspiration is recommended.
- 有其它发现ltrasound that may require some blood tests and/or another type of thyroid imaging.
Fine-needle aspiration (biopsy)
If a biopsy of the thyroid nodule is recommended, it will usually be performed on the same day, immediately after the ultrasound. Fine-needle aspiration biopsy is a very safe minor procedure. The endocrinologist will explain the procedure in detail, answer all your questions, and obtain your consent before the procedure.
With our experience of over 1,000 fine-needle aspiration procedures in children, unlike many centers we can perform thyroid fine-needle aspiration without sedation or general anesthesia for almost all children over 8 to 9 years of age. This allows us to avoid the risks and side effects of sedation, making the procedure faster and safer.
Here is how the fine-aspiration is performed:
- The topical anesthetic cream placed in advance by the nurse numbs the surface of the skin. We then use a small amount of local anesthetic to numb the area even further.
- 一旦该区域麻木，我们使用非常薄的针头从结节中服用三到六个甲状腺细胞样品。放射科医生向内分泌学家提供了采用样品的实时超声引导，这有助于获得最佳的样品，同时避免对附近结构的损坏。整个程序通常需要不到10分钟。
- The samples of thyroid cells are sent for analysis by an expert thyroid cytopathologist, who examines the cells under a microscope. Your endocrinologist will arrange a follow-up clinic visit to discuss the results of the biopsy and any further recommendations for care.
After the biopsy, a patient may experience some soreness of the neck (like a small bruise) within the first 24 hours, which is easily treated with acetaminophen. There is no scar, or activity or dietary restrictions after the biopsy.
