Viudas Sainz E, Sánchez Sempere A M, Vicente López O, Cabrera Gómez J
Medicina Familiar y Comunitaria, Consultorio Auxiliar de Chile, Valencia; Miembro del Grupo de Trabajo de Ecografía de SEMERGEN, España.
Medicina Familiar y Comunitaria, Centro de Salud Adelfas, DASE, Madrid; Miembro del Grupo de Trabajo de Ecografía de SEMERGEN, España.
Semergen. 2024 Dec;50(9):102384. doi: 10.1016/j.semerg.2024.102384. Epub 2024 Dec 5.
The thyroid nodule is a frequent lesion within the thyroid. Its incidence is between 50%-60% and most of them are asymptomatic and benign (90-95%) and its diagnosis is frequently made as an incidental finding. The main objective of their study is to rule out thyroid cancer. Cervical ultrasound is the non-invasive diagnostic technique of choice to study the thyroid gland and its pathology, including the thyroid nodule, as it is the technique with the best cost-benefit ratio. Together with the anamnesis, physical examination, personal and family history and laboratory tests, it enables the first diagnostic approach. Ultrasonography allows the description of thyroid nodules according to their structure, morphology, margins, size,echogenicity, vascularization, calcifications and whether or not there are pathological lymph nodes. Subsequently, the application of risk stratification systems, such as the TI-RADS classification, will make it possible to identify those nodules suspected of having a high risk of malignancy, establishing the indication for FNA, which is decisive for the subsequent therapeutic approach. Ultrasound therefore allows the family physician a quick orientation of the patient with a thyroid nodule, especially useful when there is a high suspicion of malignancy. As it is an operator-dependent technique, acquiring knowledge and skills in its use will increase diagnostic reliability.
甲状腺结节是甲状腺内常见的病变。其发生率在50%-60%之间,大多数结节无症状且为良性(90%-95%),其诊断常常是偶然发现。对其进行研究的主要目的是排除甲状腺癌。颈部超声是研究甲状腺及其病理情况(包括甲状腺结节)的首选非侵入性诊断技术,因为它是性价比最高的技术。结合病史、体格检查、个人及家族史以及实验室检查,它能实现初步诊断。超声检查可以根据甲状腺结节的结构、形态、边界、大小、回声性、血管形成、钙化情况以及是否存在病理性淋巴结来描述结节。随后,应用风险分层系统,如TI-RADS分类,将能够识别那些怀疑有高恶性风险的结节,确定细针穿刺抽吸活检(FNA)的指征,这对后续的治疗方法起决定性作用。因此,超声检查能让家庭医生对有甲状腺结节的患者快速做出判断,在高度怀疑恶性肿瘤时尤其有用。由于这是一项依赖操作者的技术,掌握其使用知识和技能将提高诊断的可靠性。