Schultz A L
Postgrad Med. 1986 Aug;80(2):219-20, 225-8. doi: 10.1080/00325481.1986.11699496.
Clinicians often obtain a variety of thyroid function tests in patients suspected of having thyroid disease when only a few are necessary to adequately establish a diagnosis and do follow-up. For hyperthyroidism and hypothyroidism, measurement of serum T4 is the best screening test. The serum T3 resin uptake test should be added with women suspected of being hyperthyroid because of the changes produced by pregnancy or estrogen-containing contraceptives. Various imaging techniques, including RAI, ultrasound, CT, and MRI, are often used for differentiating benign or cystic thyroid nodules from malignant or solid ones. Each of the available techniques has a different cost, and each is most suitable for a particular disorder. Special tests (eg, TRH testing and measurement of serum TBG) should be added to the basic screening tests only for questionable cases to differentiate diagnostic possibilities or confirm an uncertain diagnosis.
临床医生在怀疑患者患有甲状腺疾病时，常常会进行多种甲状腺功能测试，而实际上只需少数几项测试就能充分确立诊断并进行随访。对于甲亢和甲减，血清T4测定是最佳的筛查测试。对于因怀孕或含雌激素避孕药引起变化而怀疑患有甲亢的女性，应加做血清T3树脂摄取试验。包括放射性碘（RAI）、超声、CT和MRI在内的各种成像技术，常被用于区分甲状腺良性或囊性结节与恶性或实性结节。每种可用技术的成本不同，且每种技术都最适用于特定疾病。仅在可疑病例中，才应在基本筛查测试的基础上加做特殊测试（如促甲状腺激素释放激素（TRH）测试和血清甲状腺素结合球蛋白（TBG）测定），以区分诊断可能性或确诊不确定的诊断。
