Sonografie von Schilddrüsenknoten

Zusammenfassung

Die Sonografie gehört zu den Standardverfahren bei der Evaluation von Schilddrüsenknoten. Verschiedene sonografische Veränderungen sind mit einem erhöhten Malignitätsrisiko assoziiert. Basierend hierauf wurden in den letzten Jahren Klassifizierungssysteme entwickelt, um leichter diejenigen Knoten zu selektieren, welche einer weiteren Abklärung bedürfen (TI-RADS: thyroid imaging and reporting systems). Bis jetzt werden in diesen Systemen nur morphologische Kriterien eingeschlossen. Resultate einer Farbdoppler-Sonografie als ergänzendem Verfahren werden in diesen Klassifizierungen nicht berücksichtigt, obwohl eine erhöhte intranoduläre Vaskularisation bei follikulären Neoplasien mit einem erhöhten Malignitätsrisiko assoziiert ist. Aktuell werden die neuen Systeme evaluiert und müssen gegebenenfalls für die klinische Praxis optimiert werden. Außerdem gibt es erste Ansätze, die Dokumentation der Ultraschallergebnisse weiter zu standardisieren, um die diagnostischen Möglichkeiten der Ultraschalluntersuchung im Sinne der Verbesserung der Patientenversorgung zu optimieren.

Abstract

Thyroid ultrasound is used as a first-line diagnostic procedure to evaluate thyroid nodules. Several ultrasound characteristics have been associated with an increased risk of malignancy. Based on these criteria, classification systems are being developed to categorize thyroid nodules and stratify their malignant risk to decide about further evaluation. Up to now only morphological features are taken into account. The results of Doppler ultrasonography have not yet been included in these thyroid imaging and reporting systems (TI-RADS) although predominantly internal flow is associated with malignancy of thyroid follicular neoplasia. Currently, the new systems will be evaluated and may be optimized for clinical practice. Furthermore there are first attempts to standardize the reporting of ultrasound features of thyroid nodules to enhance patient care by optimizing the diagnostic capabilities of an ultrasound examination.

Schlüsselwörter

Sonografie - TI-RADS - Doppler-Sonografie

Key words

sonography - TI-RADS - duplex sonography

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