In my ten years of dealing with thyroid issues (including about eight thyroid ultrasounds), it seems that doctors have two things they're looking for: unusual tissue patterns (cysts, or nodules that might indicate cancer), or changes to the shape/size of the thyroid.
A gland that is enlarged (not necessarily considered a "goiter") may produce too much hormone, whereas one that appears shrunken (atrophied) may be the culprit behind someone whose blood tests suggest hypothyroidism.
Just passing along what I've been told by the docs over the years. :-) Good luck with your procedure!
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