Preoperative imaging of thyroid goiter: how imaging technique can influence anatomic appearance and create a potential for inaccurate interpretation.

The radiologist needs to be aware of a potential pitfall that can influence the imaging appearance of thyroid goiter. Whether the patient is imaged with the arms overhead or by the side may affect the apparent mediastinal excursion of a goiter. CT scans obtained with the patient's arms by the side are more accurate for determining substernal extent of goiter than when the arms are overhead, a position usually used in chest CT. Ultimately, this difference in imaging technique may have a profound effect on the adjacent structures impacted by the goiter and may influence the planned surgical approach.