Slahor L, Stettler C, Christ E R
Universitäre Poliklinik für Endokrinologie und Diabetologie, Inselspital, Universitätsspital Bern.
Praxis (Bern 1994). 2010 May 12;99(10):603-8. doi: 10.1024/1661-8157/a000105.
Thyroid nodules are a very common clinical finding with an age-related increase in prevalence. The clinical detection of thyroid nodules is outnumbered by the ultrasonographic assessment of thyroid nodules. The clinical challenge is to exclude thyroid cancer and clinical or subclinical hyperthyroidism. Ultrasonography is the first imaging study in all patients with palpable nodules; their size and TSH determine further diagnostic evaluations. Fine-needle aspiration (cytology) is recommended in euthyroid patients of nodules measuring more than 1-1.5 cm in diameter. Nodules more than 4 cm in diameter have to be removed surgically without preceding cytological examination. Without risk factors thyroid nodules are followed by clinical examination and ultrasonography every 6-12 months, in case of symptoms or rapid growth a follow-up assessment should be done earlier.
甲状腺结节是一种非常常见的临床发现，其患病率随年龄增长而增加。甲状腺结节的临床检出率低于超声对甲状腺结节的评估。临床面临的挑战是排除甲状腺癌以及临床或亚临床甲状腺功能亢进。超声检查是所有可触及结节患者的首选影像学检查；结节大小和促甲状腺激素（TSH）决定进一步的诊断评估。对于直径大于1 - 1.5厘米的甲状腺功能正常患者的结节，建议进行细针穿刺（细胞学）检查。直径大于4厘米的结节必须在不进行细胞学检查的情况下进行手术切除。没有危险因素的甲状腺结节患者每6 - 12个月进行临床检查和超声检查，如有症状或快速生长，则应更早进行随访评估。
