A hypoechoic nodule in both lobes of the thyroid gland is a description of ultrasound imaging that indicates a nodule in both lobes of the thyroid gland with low density inside the nodule, but it is impossible to determine benignity or malignancy at this time.
Ultrasound assessment of a thyroid nodule is based not only on the echogenicity but also on whether the nodule is regular and well-defined, whether there are foci of calcification inside the nodule, whether there is significant blood flow signal around the nodule, and whether the aspect ratio of the nodule is greater than 1. An experienced sonographer can make an initial determination of benignity and malignancy based on these imaging findings and grade the risk of malignancy. If the grading is above grade 4, malignancy is suspected.
When necessary, a fine-needle aspiration biopsy for cytologic pathology is required, which is currently the most accurate option for diagnosing benign and malignant thyroid other than surgery, with an accuracy rate of more than 90%. The vast majority of nodules in the bilateral lobes of the thyroid are benign.
So when ultrasound reveals bilateral hypoechoic nodules in the thyroid gland, it should be combined with other ultrasound signs to determine benignity and malignancy, and for those that are not malignant, a fine needle aspiration biopsy should be performed to clarify the diagnosis. The first of these is to make sure that the nodules are not too large or too small.