Jortay A, Fonteyn M, Ardichvili D
Chirurgie cervico-faciale, Head and Neck Center, Brussels.
Acta Chir Belg. 1988 Sep-Oct;88(5):336-45.
Value of ultrasonography and fine needle biopsy for the diagnosis of thyroid nodules. From 1/1/1986 to 31/7/1987, thirty patients with a nodular disease of the thyroid (14 solitary nodules, 9 multiple nodules, 5 colloid cysts, 2 carcinomas) were included in a controlled prospective study using clinical examination, scintigraphy, sonography and fine needle biopsy of the gland. All the patients were operated on and the specimens were submitted to pathological examination. It is shown that palpation is not able to provide an accurate evaluation of the consistancy and number of nodules. The images derived from the scintiscans were not very helpful for discerning a possible malignancy. Sonography was revealed as a fiable method of investigation (21 nodules discovered on a total of 25) allowing to find discrete lesions of 0.5 cm diameter, and also fluid collections with a high resolution rate. Needle biopsy is very useful in diagnostic studies specially for screening of remote malignant lesions with an excellent accuracy approaching 95%. Although considerable progress has been made through these methods of study, a final diagnosis about a solitary solid nodule will always need a surgical exploration to be sure to exclude the risks of an occult carcinoma of the thyroid.
超声检查和细针穿刺活检在甲状腺结节诊断中的价值。1986年1月1日至1987年7月31日,30例甲状腺结节性疾病患者(14例单发结节、9例多发结节、5例胶样囊肿、2例癌)被纳入一项前瞻性对照研究,该研究采用临床检查、闪烁扫描、超声检查及甲状腺细针穿刺活检。所有患者均接受手术治疗,标本进行病理检查。结果显示,触诊无法准确评估结节的质地和数量。闪烁扫描图像对鉴别可能的恶性病变帮助不大。超声检查被证明是一种可靠的检查方法(共发现25个结节,其中21个),能够发现直径0.5厘米的离散性病变,且对液性病变的分辨率很高。针吸活检在诊断研究中非常有用,特别是用于筛查远处恶性病变,准确率极高,接近95%。尽管通过这些研究方法取得了相当大的进展,但对于单个实性结节的最终诊断始终需要进行手术探查,以确保排除甲状腺隐匿癌的风险。