Coltrera Marc D
Department of Otolaryngology--Head and Neck Surgery, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195, USA.
Surg Oncol Clin N Am. 2008 Jan;17(1):37-56, vii-viii. doi: 10.1016/j.soc.2007.10.006.
The approach to the thyroid nodule has been incrementally modified over the past decade. The widespread adoption of fine needle aspiration in the 1980s, coupled with increased use of serial ultrasound monitoring, arguably led to the biggest changes in recommendations for surgical intervention during the past 50 years. For the office-based practitioner, thyroid nodule presentation patterns are changing with discoveries of more thyroid "incidentalomas" and with new risk assessment challenges associated with small (<1 cm) nodules. At the same time, improved primary evaluation techniques, most notably the increasing use of small, portable ultrasound imaging units, are making many clinicians more comfortable in recommending less invasive follow-up.
在过去十年中，甲状腺结节的处理方法已逐渐得到改进。20世纪80年代细针穿刺的广泛应用，再加上连续超声监测的更多使用，可以说在过去50年里，手术干预的建议发生了最大的变化。对于在门诊工作的从业者来说，随着更多甲状腺“偶发瘤”的发现以及与小（<1 cm）结节相关的新风险评估挑战，甲状腺结节的呈现模式正在发生变化。与此同时，改进的初步评估技术，最显著的是小型便携式超声成像设备的更多使用，让许多临床医生在推荐侵入性较小的随访时更加安心。
