Download PDF
Laryngorhinootologie 2019; 98(02): 79-84
DOI: 10.1055/a-0790-0849
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Sonografie von Schilddrüsenknoten

Sonografische Charakteristika und KarzinomrisikoUltrasound of Thyroid NodulesUltrasound Characteristics and Risk of Carcinoma
Daniela Schmidt
Nuklearmedizinische Klinik, Universitätsklinikum Erlangen, Erlangen
› Author Affiliations
Further Information

Publication History

Publication Date:
08 February 2019 (online)

Also available at
    Permissions and Reprints

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
 

  • Literatur

  • 1 American College of Radiology, BI-RADS Committee. ACR-BI-RADS® -ultrasound. In ACR BI-RADS breast imaging and reporting data system: breast imaging atlas. 4th ed.. Reston, VA: American College of Radiology; 2003: 1-86
    Google Scholar
  • 2 Brito JP, Gionfriddo MR, Al Nofal A. et al. The Accuracy of Thyroid Nodule Ultrasound to Predict Thyroid Cancer: Systematic Review and Meta-Analysis. J Clin Endocrinol Metab 2014; 99: 1253-1263
    CrossrefPubMedGoogle Scholar
  • 3 Cooper DS, Doherty GM, Haugen BR. et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 2009; 19: 1167-1214
    CrossrefPubMedGoogle Scholar
  • 4 Frates MC, Benson CB, Charboneau JW. et al. Management of thyroid nodules detected at US: Society of Radiologists in Ultrasound consensus conference statement. Radiology 2005; 237: 794-800
    CrossrefPubMedGoogle Scholar
  • 5 Frates MC, Benson CB, Doubilet PM. et al. Prevalence and distribution of carcinoma in patients with solitary and multiple thyroid nodules on sonography. J Clin Endocrinol Metab 2006; 91: 3411-3417
    CrossrefPubMedGoogle Scholar
  • 6 Haugen BR, Alexander EK, Bible KC. et al. American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer. The American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid 2016; 1: 1-134
    PubMedGoogle Scholar
  • 7 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; 94: 1748-1751
    CrossrefPubMedGoogle Scholar
  • 8 Iared W, Shigueoka DC, Cristófoli JC. et al. Use of color Doppler ultrasonography for the prediction of malignancy in follicular thyroid neoplasms. J Ultrasound Med 2010; 29: 419-425
    CrossrefPubMedGoogle Scholar
  • 9 Karger S, Tötsch M, Krause K. et al. Der Schilddrüsenknoten – Differentialdiagnostik und Therapiekonzepte. Medizinische Klinik 2008; 103: 575-588
    CrossrefPubMedGoogle Scholar
  • 10 Kim GR, Kim MH, Moon HJ. et al. Sonographic characteristics suggesting papillary thyroid carcinoma according to nodule size. Ann Surg Oncol 2013; 20: 906-913
    CrossrefPubMedGoogle Scholar
  • 11 Kwak JY, Han KH, Yoon JH. et al. Thyroid imaging reporting and data system for US features of nodules: a step in establishing better stratification of cancer risk. Radiology 2011; 260: 892-899
    CrossrefPubMedGoogle Scholar
  • 12 Lacout A, Chevenet C, Salas J. et al. Thyroid Doppler US: Tips and tricks. J Med Imaging and Rad Oncol 2015; 1-6
    PubMedGoogle Scholar
  • 13 Maia FF, Matos PS, Pavin EJ. et al. Thyroid imaging reporting and data system score combined with Bethesda system for malignancy risk stratification in thyroid nodules with indeterminate results on cytology. Clin Endocrinol (Oxf) 2015; 82: 439-444
    CrossrefPubMedGoogle Scholar
  • 14 Moon HJ, Kwak JY, Kim MJ. et al. Can vascularity at power Doppler US help predict thyroid malignancy?. Radiology 2010; 255: 260-269
    CrossrefPubMedGoogle Scholar
  • 15 Moon HJ, Sung JM, Kim EK. et al. Diagnostic performance of gray-scale US and elastography in solid thyroid nodules. Radiology 2012; 262: 1002-1013
    CrossrefPubMedGoogle Scholar
  • 16 Moon HJ, Kim EK, Kwak JY. Malignancy risk stratification in thyroid nodules with benign results on cytology: Combination of Thyroid Imaging Reporting and Data System and Bethesda System. Ann Surg Oncol 2014; 21: 1898-1903
    CrossrefPubMedGoogle Scholar
  • 17 Pacini F, Schlumberger M, Dralle H. et al. European consensus for the management of patients with differentiated thyroid carcinoma of the follicular epithelium. Eur J Endocrinol 2006; 154: 787-803
    CrossrefPubMedGoogle Scholar
  • 18 Papini E, Guglielmi R, Bianchini A. et al. Risk of malignancy in nonpalpable thyroid nodules: predictive value of ultrasound and color-Doppler features. J Clin Endocrinol Metab 2002; 87: 1941-1946
    CrossrefPubMedGoogle Scholar
  • 19 Park JY, Lee HJ, Jang HW. et al. A proposal for a thyroid imaging reporting and data system for ultrasound features of thyroid carcinoma. Thyroid 2009; 19: 1257-1264
    CrossrefPubMedGoogle Scholar
  • 20 Perros P, Boelaert K, Colley S. et al. Guidelines for the management of thyroid cancer. Clin Endocrinol (Oxf) 2014; 81 (Suppl. 01) 1-122
    PubMedGoogle Scholar
  • 21 Rago T, Vitti P. Role of thyroid ultrasound in the diagnostic evaluation of thyroid nodules. Best Pract Res Clin Endocrinol Metab 2008; 22: 913-928
    CrossrefPubMedGoogle Scholar
  • 22 Razavi SA, Hadduck TA, Sadigh G. et al. Comparative effectiveness of elastographic and B-mode ultrasound criteria for diagnostic discrimination of thyroid nodules: a meta-analysis. AJR Am J Roentgenol 2013; 200: 1317-1326
    CrossrefPubMedGoogle Scholar
  • 23 Remonti LR, Kramer CK, Leitão CB. et al. Thyroid ultrasound features and risk of carcinoma: a systematic review and meta-analysis of observational studies. Thyroid 2015; 25: 538-550
    CrossrefPubMedGoogle Scholar
  • 24 Russ G, Leboulleux S, Leenhardt L. et al. Thyroid incidentalomas: epidemiology, risk stratification with ultrasound and workup. Eur Thyroid J 2014; 3: 154-163
    CrossrefPubMedGoogle Scholar
  • 25 Xie C, Cox P, Taylor N. et al. Ultrasonography of thyroid nodules: a pictoral review. Insights Imaging 2016; 7: 77-86
    CrossrefPubMedGoogle Scholar
  • 26 Yeung MJ, Serpell JW. Management of the solitary thyroid nodule. Oncologist 2008; 13: 105-112
    CrossrefPubMedGoogle Scholar
  • 27 Yoon JH, Lee HS, Kim EK. Malignancy risk stratification of thyroid nodules: Comparison between the thyroid imaging reporting and data system and the 2014 American Thyroid Association management guidelines. Radiology. 2016 [epub ahead of print]
    PubMedGoogle Scholar
  • 28 Zhang J, Bo-Ji L, Xu H-X. et al. Prospective validation of an ultrasound-based thyroid imaging reporting and data system (TI-RADS) on 3980 thyroid nodules. Int J Clin Exp Med 2015; 8: 5911-5917
    PubMedGoogle Scholar