Department of Surgery, Kuma Hospital, 8-2-35 Shimoyamate-dori, Chuo-ku, Kobe, 650-0011, Japan.
World J Surg. 2010 Jun;34(6):1171-80. doi: 10.1007/s00268-009-0211-3.
The recent prevalence of ultrasonography (US) has facilitated the early detection and qualitative evaluation of thyroid nodules. Furthermore, novel technical developments are extending the application range of US for other thyroid diseases.
The use of US to differentiate between thyroid carcinoma and benign nodule, between a metastatic lymph node and a reactive node, between thyroid lymphoma and chronic thyroiditis, and between destruction-induced thyrotoxicosis and Graves' disease is introduced.
Classification systems for thyroid nodule have shown high diagnostic accuracy for thyroid carcinomas except follicular carcinoma. US diagnosis of lymph node metastasis showed high specificity but low sensitivity. Patients who were suspected of thyroid lymphoma based on US findings should undergo incisional biopsy or thyroidectomy for diagnosis of the histologic type if fine-needle aspiration biopsy findings suggest lymphoma. Patients should be carefully followed even if they were diagnosed as negative based on cytologic findings. Measurement of thyroid blood flow is helpful for diagnosing destruction-induced thyrotoxicosis, such as painless thyroiditis, by distinguishing the lesion from Graves' disease.
Ultrasonography is useful for diagnosing various thyroid diseases, including thyroid carcinoma. The remaining issue to be resolved is the diagnosis of follicular carcinoma. Trials using novel techniques to differentiate these lesions are expected.
超声检查（US）的普及有助于甲状腺结节的早期发现和定性评估。此外，新的技术发展正在扩展 US 在其他甲状腺疾病中的应用范围。
介绍了 US 在甲状腺癌与良性结节、转移性淋巴结与反应性淋巴结、甲状腺淋巴瘤与慢性甲状腺炎、破坏性甲状腺毒症与格雷夫斯病之间的鉴别诊断。
除滤泡癌外，甲状腺结节分类系统对甲状腺癌的诊断准确率较高。US 对淋巴结转移的诊断特异性高，但敏感性低。对于依据 US 检查结果怀疑为甲状腺淋巴瘤的患者，如果细针抽吸活检结果提示为淋巴瘤，则应进行切开活检或甲状腺切除术以明确组织学类型。即使根据细胞学检查结果为阴性，也应密切随访患者。测量甲状腺血流有助于通过与格雷夫斯病区分病变来诊断无痛性甲状腺炎等破坏性甲状腺毒症。
超声检查对诊断各种甲状腺疾病，包括甲状腺癌，是有用的。目前仍需要解决滤泡癌的诊断问题。预计将使用新的技术来区分这些病变。
