Ultraschall Med 2008; 29(2): 128-155
DOI: 10.1055/s-2008-1027319
CME Fortbildung/Continuing Education

© Georg Thieme Verlag KG Stuttgart · New York

Sonografie der Schilddrüse - Teil 2: Schilddrüsenentzündungen, Schilddrüsenfunktionsstörungen und Interventionen

Sonography of the Thyroid - Part 2: Thyroid Inflammation, Impairmant of Thyroid Function and InterventionsW. Blank1 , B. Braun1
  • 1Medizinische Klinik I, Klinikum am Steinenberg Reutlingen
Further Information

Publication History

eingereicht: 20.12.2007

angenommen: 26.2.2008

Publication Date:
18 April 2008 (online)

Core statements

  • Sonography of the thyroid is a method of high diagnostic certainty provided sufficient experience in the examination and good technical equipment.

  • Subacute thyroiditis de Quervain may be diagnosed conclusively by B-image sonography (hypoechoic lesions) in more than 90 % of cases if clinical symptoms (pain in the neck, laboratory signs of inflammation) are typical.

  • Following iatrogeneous hypothyroidism, chronic lymphocytic thyroiditis is the most common cause of adult hypothyroidism.

  • Clinical findings, laboratory values (thyroid hormones, and facultatively, thyroid antibodies) and color Doppler sonography findings (including PSV) are indicative in the differential diagnosis of disturbances of thyroid function.

  • Scintigraphy is employed for the diagnosis of autonomous nodules > 1 - 1.5 cm.

  • Fine-needle puncture cytology is the most precise and cost-effective procedure for confirming a diagnosis in the case of thyroid nodules suspicious of malignancy.

  • If the indication for the procedure is sound, ethanol instillation therapy (PEIT) of autonomous thyroid adenomas is an effective and, in the hands of an experienced examiner, also low-risk method which may be performed on an ambulatory basis.

Literatur/References

  • 1 Schott M, Scherbaum A. Autoimmune Schilddrüsenerkrankungen.  Deutsches Ärzteblatt 103.. 2006;  45 B2628-B2634
  • 2 Singer P A. Thyroiditis acute, subacute, and chronic.  Med Clin North Am. 1991;  75 61-77
  • 3 Birchall I W, Chow C C, Metrewelli C. Ultrasound appearances of de Quervain’s thyreoiditis.  Clin Radiol. 1990;  41 57-62
  • 4 Kujat C, Dyck R, Brederhoff J. et al . Diagnose und Therapie der subakuten Thyreoiditis de Quervain.  Dtsch Med Wschr. 1991;  116 1439-1443
  • 5 Kunz A, Blank W, Braun B. De Quervains Subacute Thyreoiditis - Colour Doppler Sonography Findings.  Ultraschall in Med. 2005;  26 1-5
  • 6 Tokuda Y, Kasagi K, Jida Y. et al . Sonography of subacute thyroiditis. Changes in the findings during the course of the disease.  J Clin Ultrasound. 1990;  18 21-25
  • 7 Vitti P, Rago T, Mazzeo S. et al . Thyroid blood flow evaluation by Color-flow Doppler ultrasonography distinguishes Graves’ disease from Hashimoto’s thyreoiditis.  J Endocrinol Invest. 1995;  18 857-61
  • 8 Rall P W, Mayekawa D S, Lee K P. et al . Color-flow Doppler sonography in Graves’ disease: „thyroid inferno”.  Am J Radiol. 1998;  150 781-784
  • 9 Baldini M, Castagnone D, Rivolta D. et al . Thyroid vascularization by color Doppler ultrasonography in Graves’ disease. Changes related to different phases and to the long-term outcome of the disease.  Thyroid. 1997;  7 823-828
  • 10 Becker D, Lohner W, Martus P. et al . Farbdopplersonographische Detektion von fokalen Schilddrüsenautonomien.  Ultraschall in Med. 1999;  20 41-46
  • 11 Clark K J, Cronan J J, Scola F H. Color doppler sonography: anatomic and physiologic assessment of the thyroid.  J Clin Ultrasound. 1995;  23 215-233
  • 12 Saleh A, Cohen B, Feldkamp J. et al . Differential diagnosis of hyperthyroidism: Doppler sonographic quantification of thyroid blood flow distinguishes between Graves’ disease and diffuse toxic goiter.  2002;  110 32-36
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  • 15 Braun B, Blank W. Farbdopplersonographisch gesteuerte perkutane Alkoholinstillation zur Therapie der funktionellen Schilddrüsenautonomie.  Dtsch med Wschr. 1994;  119 1607-1612
  • 16 Blank W, Braun B. Ethanol instillation of adenoma of the thyroid gland - a five year experience.  Min Invas Ther & Allied Technol. 1998;  7 / 6 581-588
  • 17 Lippi F, Ferrari C, Manetti L. et al . Treatment of solitary autonomous thyroid nodules by percutaneous ethanol injection: results of an Italian multicenter studie.  J Clin Endocrinol Metab. 1996;  81 3261-3264
  • 18 Janowitz P, Ackmann S. Langzeitergebnisse der ultraschallgesteuerten Alkoholinstillation bei Patienten mit fokaler Schilddrüsenautonomie und Hyperthyreose.  Med Klin. 2001;  96 341-346
  • 19 Schumm-Draeger P M. Ultrasound-Guided Percutaneous Ethanol Injection in the Treatment of Autonomous Thyroid Nodules: A Review.  Exp Clin Endocrinol Diabetes. 1998;  106 59-62
  • 20 Mauz P S, Stiegler M, Hollereied M. et al . Complications of Ultrasound Guided Percutaneous Ethanol Injection Therapie of the Thyroid and Parathyroid Glands.  Ultraschall in Med. 2005;  26 142-145

Dr. Wolfgang Blank

Medizinische Klinik I, Klinikum am Steinenberg Reutlingen

Steinenbergstr. 31

72764 Reutlingen

Phone: ++ 49/71 21/2 00 35 21

Fax: ++ 49 71 21/2 00 34 91

Email: blank_w@kreiskliniken-reutlingen.de