从上世纪60年代的低分辨率图像到现在的高分辨率技术，超声成为了甲状腺应用的首选成像模式。现场超声已将这一技术带给了甲状腺专家。结合体格检查，它提供了关于甲状腺肿大、甲状腺结节和甲状腺癌的实时信息。超声引导下的细针穿刺活检已成为被广泛接受的规范，很少使用触诊单独进行活检。超声引导下活检的优势包括：针头精确定位于结节内部、选择性采样具有可疑特征的区域以及准确将活检针指向结节周边活跃增长的存活细胞。内分泌学家在甲状腺超声方面的教育始于上世纪90年代末，2016年已有6000多名临床医生完成超声课程。与甲状腺超声使用的快速扩展同时，小乳头状癌的发现数量也增加了，否则这些癌症可能会长期缓慢发展而不被察觉。2009年美国甲状腺学会关于甲状腺结节和甲状腺癌管理的指南建议对所有固实低回声结节进行超过1cm的活检。为了减少对低风险结节的活检频率，随后的指南着重于根据超声外观识别和有选择性地对风险高的具有致命癌症可能性的甲状腺结节进行活检。甲状腺超声在术前分期和手术范围确定中发挥了重要作用，同时也用于术后对局部软组织或淋巴结转移进行监测。由于乳头状癌增加主要是由于早期诊断小的、通常是缓慢的癌症，主动监测已成为管理乳头状甲状腺微小癌的一种有希望的策略。甲状腺超声对于主动监测甲状腺癌至关重要，易于获得高质量的超声研究对于成功的主动监测方案是必需的。甲状腺超声已用于促进介入性操作，包括甲状腺结节治疗、复发性甲状腺癌治疗和乳头状甲状腺微小癌治疗。

From low-resolution images in the 1960s to current high-resolution technology, ultrasound has proven to be the initial imaging modality of choice for thyroid application. Point-of-care ultrasound has brought the technology to the thyroid specialist. Combined with physical examination, it provides real-time information regarding goiter, thyroid nodules, and thyroid cancer. Ultrasound-guided fine-needle aspiration biopsy has become the accepted norm, with biopsies rarely performed using palpation alone. Advantages of ultrasound-guided biopsy include precise placement of the needle within the nodule, selective sampling of areas with suspicious features, and accurate direction of the biopsy needle to actively growing viable cells in the periphery of the nodule. Education of endocrinologists in thyroid ultrasound began in the late 1990s and by 2016 more than 6000 clinicians had completed an ultrasound course. Concurrent with this rapid expansion of use of thyroid ultrasound was a rise in the diagnosis of small papillary carcinomas, which might have otherwise remained indolent and undetected. The 2009 American Thyroid Association Guidelines for the Management of Thyroid Nodules and Thyroid Cancer recommended biopsy for all solid hypoechoic nodules measuring larger than 1 cm. Attempting to decrease the frequency of biopsies of low-risk nodules, subsequent guidelines have focused on identifying and selectively biopsying those thyroid nodules at higher risk of clinically significant carcinoma based on ultrasound appearance. A major role for thyroid ultrasound has been in both preoperative staging and mapping to help determine the extent of surgery, as well as postoperative monitoring for locoregional soft tissue or lymph node metastases. With the recognition that the increase in papillary carcinoma was predominantly a result of early diagnosis of small often indolent cancers, active surveillance has become a promising management strategy for papillary thyroid microcarcinomas. Thyroid ultrasound is essential to active surveillance of thyroid cancer. Easy access to high-quality ultrasound studies is a requirement for a successful active surveillance program. Thyroid ultrasound has been used to facilitate interventional procedures, including treatment of thyroid nodules, treatment of recurrent thyroid cancer, and therapy of papillary thyroid microcarcinoma.