Naoun A
Service de Médecine Nucléaire et d'Ostéodensitométrie, Epinal.
Ann Endocrinol (Paris). 1993;54(4):232-4.
Purpose of the paper: Specify the merits of ultrasonography in thyroid pathology. Outline ultrasonographic orienting criteria to identify the nature of thyroid nodules. Analysis of the paper: Thyroid ultrasonography allows detecting nodules that cannot be detected clinically or with radionuclide scanning. 20% of sonographic nodules cannot be palpated; 33% of sonographic nodules are not visible on radionuclide scans. Ultrasonography often shows multiple nodules where palpation and/or radionuclide scanning detect only one. When there are clinical signs of hyperthyroidism and uncertain biological findings, ultrasonography can relate a low-uptake nodule with an adenoma becoming autonomous, if the nodule appears to be hypodense. It allows monitoring the volume of nodules under freination therapy. Benign nodules may be liquid (15.7% of all cases); solid and isoechogenic (27.6%); solid and hyperechogenic (10.1%); solid and hypoechogenic (18.1%, including 88.5% toxic adenomas) or compound (26.4%). Comparison of the 2 series of nodules reveals the predominance of liquid and iso/hyperechogenic solid appearances for benign nodules (63.8%, excluding toxic adenomas). For cancers, the frequency of hypodense solid or compound nodules is 92.2%. Combining radionuclide scanning and ultrasonography allows further restricting the group of suspicious nodules, which have a low uptake and are hypodense or compound.
明确超声检查在甲状腺病理学中的优点。概述用于识别甲状腺结节性质的超声定位标准。论文分析：甲状腺超声检查能够检测出临床或放射性核素扫描无法检测到的结节。20%的超声检查发现的结节无法触及；33%的超声检查发现的结节在放射性核素扫描中不可见。超声检查常常显示出多个结节，而触诊和/或放射性核素扫描仅检测到一个。当存在甲状腺功能亢进的临床体征且生物学检查结果不确定时，如果结节表现为低密度，超声检查可将摄取低的结节与自主性腺瘤相关联。它能够监测抑制治疗下结节的体积。良性结节可能为液性（占所有病例的15.7%）；实性且等回声（27.6%）；实性且高回声（10.1%）；实性且低回声（18.1%，包括88.5%的毒性腺瘤）或混合性（26.4%）。对两组结节的比较显示，良性结节以液性以及等回声/高回声实性表现为主（63.8%，不包括毒性腺瘤）。对于癌症，低密度实性或混合性结节的发生率为92.2%。将放射性核素扫描和超声检查相结合能够进一步缩小可疑结节的范围，这些结节摄取低且为低密度或混合性。
