Cox M R, Marshall S G, Spence R A
Belfast City Hospital.
Br J Surg. 1991 Jan;78(1):90-3. doi: 10.1002/bjs.1800780128.
The aim of this study was to assess prospectively the value of thyroid nuclear scans and ultrasound examination in the preoperative investigation of patients with a solitary thyroid nodule. Total thyroid lobectomy for a solitary thyroid nodule was performed in 68 cases. Each patient had a thyroid isotope scan (except two women who were pregnant) and thyroid ultrasound examination. There were 10 (15 per cent) malignant nodules, 11 (16 per cent) benign neoplastic nodules and 47 (69 per cent) benign non-neoplastic nodules. All of the patients with malignant nodules who were scanned had a solitary cold nodule on thyroid scan, as did 40 (69 per cent) of those with benign solitary nodules. Ultrasound examination of the thyroid suggested correctly that one of 16 (6 per cent) cystic lesions, four of 16 (25 per cent) complex solid-cystic lesions and three of 18 (17 per cent) of solid lesions were malignant. One lesion reported as multinodular on ultrasonography and one reported as normal also turned out to be malignant. Thyroid isotope scans and ultrasound do not accurately differentiate between benign and malignant conditions and their routine use in the investigation of a solitary thyroid nodule should be abandoned.
本研究的目的是前瞻性评估甲状腺核素扫描和超声检查在孤立性甲状腺结节患者术前检查中的价值。对68例孤立性甲状腺结节患者实施了甲状腺叶全切除术。每位患者均进行了甲状腺同位素扫描（两名孕妇除外）和甲状腺超声检查。其中有10个（15%）恶性结节、11个（16%）良性肿瘤性结节和47个（69%）良性非肿瘤性结节。所有接受扫描的恶性结节患者在甲状腺扫描中均显示为孤立性冷结节，良性孤立性结节患者中也有40个（69%）显示为孤立性冷结节。甲状腺超声检查正确提示，16个（6%）囊性病变中有1个、16个（25%）复杂实性-囊性病变中有4个以及18个（17%）实性病变中有3个为恶性。超声检查报告为多发结节的1个病变以及报告为正常的1个病变也被证实为恶性。甲状腺同位素扫描和超声检查无法准确区分良性和恶性情况，应摒弃它们在孤立性甲状腺结节检查中的常规应用。
