Leenhardt L
Service, Hôpital de la Pitié, Paris.
Ann Endocrinol (Paris). 1993;54(4):237-40.
Thyroid ultrasonography does not allow establishing a positive diagnosis as to the benign or malignant nature of a thyroid nodule. However, the predictive value of this technique should be studied on the basis of recent technological progress. The great power of resolution of current sonographic systems allows a fine semiological analysis of the features of nodules. Presumption factors such as the solid, hypoechogenic nature, predictive of cancer in 35 to 63% of cases according to series, can be gathered. Thus ultrasonography can be placed in its right place for decision in the diagnostic strategy for a cold nodule; this place is better than that of radionuclide scanning, and close to that of cytology. This technological progress involves an increase in the prevalence of thyroid nodules. Multiple infraclinical micronodules, visible on ultrasonography but with uncertain pathological significance, are demonstrated. While ultrasonography has a disputable predictive value in such cases, it still is the technique of choice for the surveillance of such nodules. Sonographic guidance of cytological puncture of thyroid nodules, doppler studies of nodule vasculature and computer-supported analysis of its texture are interesting capabilities that may allow increasing the diagnostic efficiency of thyroid ultrasonography.
甲状腺超声检查无法对甲状腺结节的良恶性做出肯定诊断。然而，应基于近期的技术进展来研究该技术的预测价值。当前超声系统强大的分辨率使得对结节特征进行精细的符号学分析成为可能。一些推测因素，如实性、低回声性质，根据不同系列报道，在35%至63%的病例中提示癌症，这些因素可以被收集起来。因此，在冷结节的诊断策略中，超声检查可以在决策过程中发挥其应有的作用；其作用优于放射性核素扫描，与细胞学检查相近。这种技术进展导致甲状腺结节的患病率增加。超声检查显示出多个亚临床微小结节，但其病理意义尚不明确。虽然超声检查在这些病例中的预测价值存在争议，但它仍然是监测此类结节的首选技术。甲状腺结节细胞学穿刺的超声引导、结节血管的多普勒研究以及对其纹理的计算机辅助分析都是很有意义的功能，可能会提高甲状腺超声检查的诊断效率。
