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Dtsch Med Wochenschr 2015; 140(08): 565-572
DOI: 10.1055/s-0041-101539
Dossier
Schilddrüsenknoten
© Georg Thieme Verlag KG Stuttgart · New York

Wie werden Schilddrüsenknoten diagnostiziert?

How are thyroid nodules diagnosed?
Andreas Pfestroff
1   Klinik für Nuklearmedizin, Universitätsklinikum Marburg
,
Markus Luster
1   Klinik für Nuklearmedizin, Universitätsklinikum Marburg
› Author Affiliations
Further Information

Publication History

Publication Date:
01 April 2015 (online)

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Zusammenfassung

Die Prävalenz von Schilddrüsenknoten liegt in Deutschland – je nach Untersuchungstechnik – bei 20 bis 50 %. Die Inzidenz steigt, denn durch moderne Ultraschallverfahren können immer kleinere morphologische Veränderungen entdeckt werden. Die meisten Knoten sind asymptomatisch – und daher häufig Zufallsbefunde. In diesem Beitrag erfahren Sie, wie Sie mit Hilfe verschiedener diagnostischer Methoden Schilddrüsenknoten erkennen und differenzieren können.

Abstract

The prevalence of thyroid nodules in Germany – depending on the diagnostic technique used – ranges from 20 to 50 %. The overall incidence increases, partly because by the use of modern ultrasound modalities ever smaller morphological changes are detected. Most nodules are asymptomatic – and therefore often incidental findings. In this article you will learn how to identify and differentiate thyroid nodules using different diagnostic tests.

Schlüsselwörter

Schilddrüsenknoten - Papilläres Schilddrüsenkarzinom - Szintigrafie

Keywords

thyroid nodules - papillary carcinoma of the thyroid - scintigraphy
 

  • Literatur

  • 1 Reiners C. Thyroid gland ultrasound screening (Papillon Initiative). Report of 15 incidentally detected thyroid cancers]. Internist 2003; 44: 412-419
    CrossrefPubMedGoogle Scholar
  • 2 Völzke H et al. The prevalence of undiagnosed thyroid disorders in a previously iodine-deficient area. Thyroid  2003; 13: 803-810
    CrossrefPubMedGoogle Scholar
  • 3 Frates MC et al. Management of thyroid nodules detected at US: Society of Radiologists in Ultrasound consensus conference statement. Radiology 2005; 237: 794-800
    CrossrefPubMedGoogle Scholar
  • 4 Wiest PW. Thyroid palpation versus high-resolution thyroid ultrasonography in the detection of nodules. J Ultrasound Med 1998; 17: 487-496
    PubMedGoogle Scholar
  • 5 Ruhlmann M, Stebner V, Görges R et al. Diagnostik hyperfunktioneller Schilddrüsenknoten. Bedeutung der US-Elastographie. Nuklearmedizin 2014; 53: 173-177
    Article in Thieme ConnectPubMedGoogle Scholar
  • 6 Dietlein M, Eschner W, Lassmann M et al. Procedure guideline for thyroid scintigraphy (version 4). Nuklearmedizin 2014; in press
    PubMedGoogle Scholar
  • 7 Schicha H, Hellmich M, Lehmacher W et al. Should all patients with thyroid nodules ≥ 1 cm undergo fine-needle aspiration biopsy?. Nuklearmedizin 2009; 48: 79-83
    Article in Thieme ConnectPubMedGoogle Scholar
  • 8 Brito JP, Morris JC, Montori VM. Thyroid cancer: zealous imaging has increased detection and treatment of low risk tumours. BMJ 2013; 347: f4706
    CrossrefPubMedGoogle Scholar
  • 9 Ross DS, Tuttle RM. Observing micopapillary thyroid cancers. Thyroid 2014; 24: 3-6
    CrossrefPubMedGoogle Scholar
  • 10 Ito Y, Miyauchi A, Kihara M et al. Patient age is significantly related to the progression of papillary microcarcinoma of the thyroid under observation. Thyroid 2014; 24: 27-34
    CrossrefPubMedGoogle Scholar
  • 11 Sugitani I, Toda K, Yamada K et al. Three distinctly different kinds of papillary thyroid microcarcinoma should be recognized: our treatment strategies and outcomes. World J Surg 2010; 34: 1222-1231
    CrossrefPubMedGoogle Scholar
  • 12 Luster M, Weber T, Verburg FA. Differentiated thyroid cancer-personalized therapies to prevent overtreatment. Nat Rev Endocrinol 2014; 10: 563-574
    CrossrefPubMedGoogle Scholar
  • 13 Theissen P, Schmidt M, Ivanova T. MIBI scintigraphy in hypofunctioning thyroid nodules – can it predict the dignity of the lesion?. Nuklearmedizin 2009; 48: 144-152
    Article in Thieme ConnectPubMedGoogle Scholar
  • 14 Cooper DS, Doherty GM, Haugen BR et al. Revised American Thyroid Association Management Guidelines for Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid 2009; 19: 1167-1214
    Google Scholar
  • 15 Gharib H, Papini E, Paschke R et al. American Association of Clinical Endocrinologists, Assoziatione Medici Endocrinologi, European Thyroid Association Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules. Endocr Pract 2010; 16 (Suppl. 01) 1-43
    CrossrefPubMedGoogle Scholar
  • 16 Nikiforov YE, Nikiforova MN. Molecular genetics and diagnosis of thyroid cancer. Nat Rev Endocrinol 2011; 7: 569-580
    CrossrefPubMedGoogle Scholar
  • 17 Alexander EK, Kennedy GC, Baloch ZW et al. Preoperative diagnosis of benign thyroid nodules with indeterminate cytology. N Engl J Med 2012; 367: 705-715
    CrossrefPubMedGoogle Scholar
  • 18 Harrell RM, Bimston DN. Surgical utility of Afirma: effects of high cancer prevalence and oncocytic cell types in patients with indeterminate thyroid cytology. Endocrine Practice 2014; 20: 364-369
    CrossrefPubMedGoogle Scholar
  • 19 Schneider C, Kobe C, Schmidt M et al. Calcitonin screening in patients with thyroid nodules. Diagnostic value. Nuklearmedizin 2012; 51: 228-233
    Article in Thieme ConnectPubMedGoogle Scholar
  • 20 Dralle H. Inzidentalome der Schilddrüse. Überdiagnostik- und Therapie gesunder Schilddrüsenkranker?. Chirurg 2007; 78: 677-686
    CrossrefPubMedGoogle Scholar
  • 21 Horvath E, Majlis S, Rossi R et al. An Ultrasonogram Reporting System for Thyroid Nodules Stratifying Cancer Risk for Clinical Management. J Clin Endocrinol Metab 2009; 90: 1748-1751
    PubMedGoogle Scholar