Uchino Shinya, Noguchi Shiro
Noguchi Thyroid Clinic and Hospital Foundation.
Nihon Rinsho. 2007 Nov;65(11):2016-20.
Thyroid nodules are common disease in general population. The current gold standard for diagnosis of thyroid nodules is ultrasonographic screening and fine needle aspiration biopsy cytology under ultrasonography. Laboratory testing for thyroid function should be examined in order to discriminate non-functioning nodules from autonomous functioning thyroid nodule, combination with Graves' disease, chronic thyroiditis and subacute thyroiditis. Thyroid scintigraphy is necessary when the thyroid function test shows abnormal values. Neck X-ray can detect presence or absence of calcification and tracheal shift or stenosis due to the thyroid nodule. Neck MRI and CT are useless examination for thyroid nodule except for giant goiter or intrathoracic goiter. In this article, we present a current, rational diagnostic strategy to the patients with a thyroid nodule.
甲状腺结节是普通人群中的常见疾病。目前诊断甲状腺结节的金标准是超声筛查以及在超声引导下进行细针穿刺活检细胞学检查。应进行甲状腺功能实验室检测,以区分无功能结节与自主功能性甲状腺结节、合并格雷夫斯病、慢性甲状腺炎和亚急性甲状腺炎的情况。当甲状腺功能检查显示异常值时,甲状腺闪烁扫描是必要的。颈部X线检查可检测甲状腺结节是否存在钙化以及是否导致气管移位或狭窄。除巨大甲状腺肿或胸内甲状腺肿外,颈部MRI和CT对甲状腺结节检查并无用处。在本文中,我们为甲状腺结节患者提出了一种当前合理的诊断策略。