Braun B, Blank W
Klinikum am Steinenberg, Kreiskliniken, 72710, Reutlingen.
Internist (Berl). 2006 Jul;47(7):729-46; quiz 747. doi: 10.1007/s00108-006-1598-7.
Ultrasonography is the most important imaging tool in the diagnosis of thyroid disease. The results of real-time B-imaging of the thyroid gland along with physical signs and basal TSH can aid in the diagnosis of thyroid dysfunction, of for instance, a small, hypoechogenic gland in Hashimoto's and radiation thyroiditis, or an enlarged, hypoechogenic and pulsating gland in Graves' disease. Although recent improvements in technology have increased sensitivity of colored duplexsonography, certain sonographic differentiation of benign and malignant lesions as well as of active (hormone secreting) and inactive nodules is not yet possible. Diagnostic interpretation of ultrasonographic findings is feasible only when the history of the patient, physical examination and the laboratory evaluation are taken into account. Ultrasound detects thyroid nodules, is useful for following nodule size, in guiding fine needle biopsies and in the aspiration of cysts. Highly experienced investigators in ultrasound can assist preoperatively in the localization of parathyroid adenomas in primary and tertiary hyperthyroidism (when followed by (99m)Tc szintigraphy plus SPECT).
超声检查是诊断甲状腺疾病最重要的影像学工具。甲状腺实时B超成像结果结合体征和基础促甲状腺激素（TSH），有助于诊断甲状腺功能障碍，例如，桥本甲状腺炎和放射性甲状腺炎时甲状腺腺体小且回声减低，或格雷夫斯病时甲状腺腺体增大、回声减低且有搏动。尽管最近技术的改进提高了彩色双功超声的敏感性，但目前仍无法通过超声对良性和恶性病变以及活性（激素分泌性）和非活性结节进行某些鉴别诊断。只有将患者病史、体格检查和实验室评估考虑在内，超声检查结果的诊断性解读才可行。超声可检测甲状腺结节，有助于监测结节大小、引导细针穿刺活检及囊肿抽吸。经验丰富的超声检查人员可在术前协助定位原发性和继发性甲状旁腺功能亢进症中的甲状旁腺腺瘤（随后进行（99m）锝闪烁扫描加单光子发射计算机断层扫描（SPECT））。
