Download PDF
Endoskopie heute 2007; 20(1): 17-27
DOI: 10.1055/s-2007-960561
Übersicht

© Georg Thieme Verlag Stuttgart · New York

Schilddrüsensonografie: Eine Übersicht

Sonography of the Thyroid Gland - A SummaryC. F. Dietrich1 , J. G. Schneider2 , A. Ignee1
  • 1Innere Medizin 2, Caritaskrankenhaus Bad Mergentheim
  • 2Abteilung für Nuklearmedizin, Caritaskrankenhaus Bad Mergentheim
Further Information

Publication History

Publication Date:
16 March 2007 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Die Schilddrüsensonografie ist aufgrund ihrer Verfügbarkeit und Aussagekraft das bildgebende Verfahren der Wahl mit hoher Sensitivität, jedoch relativ geringer Spezifität. Neue Studien zeigen, dass davon auszugehen ist, dass jeder dritte Berufstätige in Deutschland entweder eine Struma oder knotige Veränderungen oder beides hat. Diese Tatsache macht eine effektive Frühdiagnose erforderlich. Die Sonografie ist der maßgebliche Baustein im diagnostischen Konzept, bedarf aber häufig der Ergänzung durch labormedizinische, szintigrafische oder zytologische Informationen.

Abstract

Ultrasound examination of the thyroid gland is widely used, easily performed resulting in a high sensitivity but relative low specifity in identifying thyroid disorders. It is obvious that every third working german reveal diffuse and / or nodular thyroid disease. The most frequent thyroid pathology is without doubt goitre. The high frequency of thyroid disorders implies effective diagnostic strategies. Ultrasonography is the most important imaging modality of the thyroid but laboratory tests, scintigraphy and cytology results are indicative for final diagnosis.

Schlüsselwörter

Sonografie, hochauflösend - Signalverstärker - Elastografie - Farbkodierte Dopplersonografie - Schilddrüsenknoten - diffuse Schilddrüsenerkrankungen

Key words

sonography, high resolution - contrast agents - elastography - colour coded doppler sonography - thyroid nodules - diffuse thyroid diseases

Literatur

  • 1 Pfannenstiel P. Schilddrüsenreport. 1997
    Google Scholar
  • 2 Alberti A, Giannetto G, Basile G, Dattola A, Basile M. [Preoperative diagnosis using color Doppler flowmetry in focal and diffuse thyroid pathology].  Chir Ital. 1999;  51 73-78
    PubMedGoogle Scholar
  • 3 Angelillis L, Urso M, Ambrosio G B. [The use of color Doppler sonography in the diagnosis of thyroid pathology].  Minerva Endocrinol. 1995;  20 225-232
    PubMedGoogle Scholar
  • 4 Argalia G, Mignosi U, Lucarelli F, Morosini P P, Aglieri V, Giuseppetti G M. [Doppler color ultrasonography in the diagnosis of diffuse hyperthyroidism].  Radiol Med (Torino). 1997;  93 61-66
    PubMedGoogle Scholar
  • 5 Bogazzi F. et al . Thyroid vascularity and blood flow are not dependent on serum thyroid hormone levels: studies in vivo by color flow Doppler sonography.  Eur J Endocrinol. 1999;  140 452-456
    CrossrefPubMedGoogle Scholar
  • 6 Boi F, Piga M, Loy M, Mariotti S. Hypothyroid Hashimoto's thyroiditis with scintigraphic and echo-color Doppler features mimicking autonomous adenoma.  J Endocrinol Invest. 2002;  25 469-472
    CrossrefPubMedGoogle Scholar
  • 7 Bozbora A, Erbil Y, Ozarmagan S, Barbaros U, Sari S, Degirmenci B. Color Doppler sonography in cold thyroid nodules for malignancy prediction.  Acta Chir Belg. 2002;  102 259-262
    PubMedGoogle Scholar
  • 8 Clark K J, Cronan J J, Scola F H. Color Doppler sonography: anatomic and physiologic assessment of the thyroid.  J Clin Ultrasound. 1995;  23 215-223
    CrossrefPubMedGoogle Scholar
  • 9 Bude R O, Rubin J M. Power Doppler sonography.  Radiology. 1996;  200 21-23
    PubMedGoogle Scholar
  • 10 Delorme S, Weisser G, Zuna I, Fein M, Lorenz A, van Kaick G. Quantitative characterization of color Doppler images: reproducibility, accuracy, and limitations.  J Clin Ultrasound. 1995;  23 537-550
    PubMedGoogle Scholar
  • 11 Gooding G A, Clark O H. Use of color Doppler imaging in the distinction between thyroid and parathyroid lesions.  Am J Surg. 1992;  164 51-56
    CrossrefPubMedGoogle Scholar
  • 12 Hiromatsu Y. et al . Color Doppler ultrasonography in patients with subacute thyroiditis.  Thyroid. 1999;  9 1189-1193
    CrossrefPubMedGoogle Scholar
  • 13 Hubsch P. et al . [Color-coded Doppler sonography of the thyroid: an advance in carcinoma diagnosis?].  Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr. 1992;  156 125-129
    PubMedGoogle Scholar
  • 14 Klemenz B, Wieler H, Kaiser K P. [Value of color-coded Doppler sonography in the differential diagnosis of nodular thyroid gland changes].  Nuklearmedizin. 1997;  36 245-249
    PubMedGoogle Scholar
  • 15 Rogula T, Cichon S. [Ultrasonographic evaluation of thyroid tissue perfusion in patients with Graves-Basedow disease as preparation for surgery].  Folia Med Cracov. 2000;  41 121-129
    PubMedGoogle Scholar
  • 16 Schweiger U. et al . [Duplex sonography in functional thyroid diagnosis].  Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr. 1996;  164 114-118
    PubMedGoogle Scholar
  • 17 Varsamidis K, Varsamidou E, Mavropoulos G. Doppler ultrasonography in predicting relapse of hyperthyroidism in Graves' disease.  Acta Radiol. 2000;  41 45-48
    CrossrefPubMedGoogle Scholar
  • 18 Vitti P. et al . Thyroid blood flow evaluation by color-flow Doppler sonography distinguishes Graves' disease from Hashimoto's thyroiditis.  J Endocrinol Invest. 1995;  18 857-861
    CrossrefPubMedGoogle Scholar
  • 19 Wang C Y, Chang T C. Thyroid Doppler ultrasonography and resistive index in the evaluation of the need for ablative or antithyroid drug therapy in Graves' hyperthyroidism.  J Formos Med Assoc. 2001;  100 753-757
    PubMedGoogle Scholar
  • 20 Recommended normative values for thyroid volume in children aged 6-15 years. World Health Organization & International Council for Control of Iodine Deficiency Disorders.  Bull World Health Organ. 1997;  75 95-97
    PubMedGoogle Scholar
  • 21 Brunn J, Block U, Ruf G, Bos I, Kunze W P, Scriba P C. [Volumetric analysis of thyroid lobes by real-time ultrasound (author's transl)].  Dtsch Med Wochenschr. 1981;  106 1338-1340
    Article in Thieme ConnectPubMedGoogle Scholar
  • 22 Gutekunst R, Smolarek H, Wachter W, Scriba P C. [Goiter epidemiology. IV. Thyroid volumes in German and Swedish school children].  Dtsch Med Wochenschr. 1985;  110 50-54
    PubMedGoogle Scholar
  • 23 Igl W. et al . [Sonographic determination of thyroid volume. Comparison with other methods (author's transl.)].  Nuklearmedizin. 1981;  20 64-71
    PubMedGoogle Scholar
  • 24 Nygaard B. et al . Thyroid volume measured by ultrasonography and CT.  Acta Radiol. 2002;  43 269-274
    CrossrefPubMedGoogle Scholar
  • 25 Pickardt C R. [Sonographic determination of thyroid volume].  Dtsch Med Wochenschr. 1982;  107 426-427
    PubMedGoogle Scholar
  • 26 Reinartz P. et al . Thyroid volume measurement in patients prior to radioiodine therapy: comparison between three-dimensional magnetic resonance imaging and ultrasonography.  Thyroid. 2002;  12 713-717
    CrossrefPubMedGoogle Scholar
  • 27 Rendl J, Juhran N, Reiners C. Thyroid volumes and urinary iodine in German school children.  Exp Clin Endocrinol Diabetes. 2001;  109 8-12
    Article in Thieme ConnectPubMedGoogle Scholar
  • 28 Schlogl S. et al . The use of three-dimensional ultrasound for thyroid volumetry.  Thyroid. 2001;  11 569-574
    CrossrefPubMedGoogle Scholar
  • 29 Kassenärztliche Bundesvereinigung .Ultraschall Richtlinien. 1987
    Google Scholar
  • 30 Sektion Schilddrüse der Deutschen Gesellschaft für Endokrinologie . Diagnostik und Therapie von Schilddrüsenkrankheiten. Empfehlungen zur Qualitaetssicherung. Teil I.  Internist (Berl). 2003;  38 177-185
    PubMedGoogle Scholar
  • 31 Frank T. [Ultrasound in the diagnosis of thyroid disease (author's transl.)].  Rontgenblatter. 1980;  33 386-394
    PubMedGoogle Scholar
  • 32 Schreck-Kollner H, Muller H, Grebe S F. [Ultrasound diagnosis of the thyroid].  Radiologe. 1984;  24 461-467
    PubMedGoogle Scholar
  • 33 Rummeny E. et al . [Thyroid gland diagnosis by image-producing procedures. 3. Radiological procedures and NMR tomography].  Fortschr Med. 1986;  104 367-371
    PubMedGoogle Scholar
  • 34 Rummeny E. et al . [Thyroid diagnosis with image producing procedures. 2: Technic and results of modern thyroid scintigraphy].  Fortschr Med. 1986;  104 83-85
    PubMedGoogle Scholar
  • 35 Rummeny E. et al . [Thyroid gland diagnosis with image-producing procedures. 1: Ultrasound].  Fortschr Med. 1985;  103 1035-1040
    PubMedGoogle Scholar
  • 36 Pfannenstiel P. [Therapy of endemic goiter with levothyroxine and iodide. A multicenter study].  Dtsch Med Wochenschr. 1988;  113 326-331
    PubMedGoogle Scholar
  • 37 Hayashi N. et al . Sonography of Hashimoto's thyroiditis.  J Clin Ultrasound. 1986;  14 123-126
    CrossrefPubMedGoogle Scholar
  • 38 Set P A, Oleszczuk-Raschke K, Lengerke von J H, Bramswig J. Sonographic features of Hashimoto thyroiditis in childhood.  Clin Radiol. 1996;  51 167-169
    CrossrefPubMedGoogle Scholar
  • 39 Sostre S, Reyes M M. Sonographic diagnosis and grading of Hashimoto's thyroiditis.  J Endocrinol Invest. 1991;  14 115-121
    CrossrefPubMedGoogle Scholar
  • 40 Yeh H C, Futterweit W, Gilbert P. Micronodulation: ultrasonographic sign of Hashimoto thyroiditis.  J Ultrasound Med. 1996;  15 813-819
    PubMedGoogle Scholar
  • 41 Zieleznik W, Peszel-Barlik M, Sieron A. [Ultrasonographic imaging in the early phase of Hashimoto disease].  Wiad Lek. 2000;  53 518-521
    PubMedGoogle Scholar
  • 42 Bohuslavizki K H, Henze E, Schwaiger M, Clausen M. Standardized annotation of nuclear medicine images.  J Nucl Med Technol. 2000;  28 96-103
    PubMedGoogle Scholar
  • 43 Arslan H, Unal O, Algun E, Harman M, Sakarya M E. Power Doppler sonography in the diagnosis of Graves' disease.  Eur J Ultrasound. 2000;  11 117-122
    CrossrefPubMedGoogle Scholar
  • 44 Chang T C, Hong C T, Chang S L, Hsieh H C, Liaw K Y, How S W. Correlation between sonography and pathology in thyroid diseases.  J Formos Med Assoc. 1990;  89 777-783
    PubMedGoogle Scholar
  • 45 Espinasse P, Desuzinges C, Cercassi J C. Measurements of an index of echogenicity in some thyroid diseases.  J Clin Ultrasound. 1984;  12 33-36
    CrossrefPubMedGoogle Scholar
  • 46 King A D, Chow F C, Ahuja A T, Richards P S. Thyrotoxic periodic paralysis: sonographic appearances of the thyroid.  J Clin Ultrasound. 2002;  30 544-547
    CrossrefPubMedGoogle Scholar
  • 47 Vitti P. et al . Thyroid hypoechogenic pattern at ultrasonography as a tool for predicting recurrence of hyperthyroidism after medical treatment in patients with Graves' disease.  Acta Endocrinol (Copenh). 1992;  126 128-131
    PubMedGoogle Scholar
  • 48 Vitti P. Grey scale thyroid ultrasonography in the evaluation of patients with Graves' disease.  Eur J Endocrinol. 2000;  142 22-24
    CrossrefPubMedGoogle Scholar
  • 49 Yoshida A. et al . Echographic findings and histological feature of the thyroid: a reverse relationship between the level of echo-amplitude and lymphocytic infiltration.  Endocrinol Jpn. 1985;  32 681-690
    PubMedGoogle Scholar
  • 50 Zielke T. et al . [Quantitative technics in ultrasonic diagnosis].  Radiologe. 1985;  25 468-473
    PubMedGoogle Scholar
  • 51 Adams H, Jones M C. Ultrasound appearances of De Quervain's thyroiditis.  Clin Radiol. 1990;  42 217-221
    PubMedGoogle Scholar
  • 52 Benker G. et al . The sonographical and functional sequelae of de Quervain's subacute thyroiditis: long-term follow-up.  Acta Endocrinol (Copenh). 1988;  117 435-441
    PubMedGoogle Scholar
  • 53 Birchall I W, Chow C C, Metreweli C. Ultrasound appearances of de Quervain's thyroiditis.  Clin Radiol. 1990;  41 57-59
    CrossrefPubMedGoogle Scholar
  • 54 Brander A. Ultrasound appearances in de Quervain's subacute thyroiditis with long-term follow-up.  J Intern Med. 1992;  232 321-325
    PubMedGoogle Scholar
  • 55 Cordray J P, Nys P, Merceron R E, Augusti A. [Frequency of hypothyroidism after De Quervain thyroiditis and contribution of ultrasonographic thyroid volume measurement].  Ann Med Interne (Paris). 2001;  152 84-88
    PubMedGoogle Scholar
  • 56 Kujat C, Dyck R, Brederhoff J, Pfannenstiel P. [The diagnosis and therapy of de Quervain's subacute thyroiditis].  Dtsch Med Wochenschr. 1991;  116 1439-1443
    PubMedGoogle Scholar
  • 57 Creagh F M. et al . The iodide perchlorate discharge test in women with previous post-partum thyroiditis: relationship to sonographic appearance and thyroid function.  Clin Endocrinol (Oxf). 1994;  40 765-768
    CrossrefPubMedGoogle Scholar
  • 58 Parkes A B. et al . Serum thyroglobulin: an early indicator of autoimmune post-partum thyroiditis.  Clin Endocrinol (Oxf). 1994;  41 9-14
    PubMedGoogle Scholar
  • 59 Rasmussen N G, Hornnes P J, Hegedus L. Ultrasonographically determined thyroid size in pregnancy and post partum: the goitrogenic effect of pregnancy.  Am J Obstet Gynecol. 1989;  160 1216-1220
    PubMedGoogle Scholar
  • 60 Reinhardt W. et al . Efficacy and safety of iodine in the postpartum period in an area of mild iodine deficiency.  Eur J Med Res. 1998;  3 203-210
    PubMedGoogle Scholar
  • 61 Becker D. et al . Thyroid autonomy with color-coded image-directed Doppler sonography: internal hypervascularization for the recognition of autonomous adenomas.  J Clin Ultrasound. 1997;  25 63-69
    CrossrefPubMedGoogle Scholar
  • 62 Baum K, Reiners C, Wiedemann W, Muller H A, Borner W. [Differential diagnosis of thyroid nodules. Sonography as a complement to scintigraphy and puncture cytology].  Dtsch Med Wochenschr. 1983;  108 1359-1364
    PubMedGoogle Scholar
  • 63 Wiedemann W, Reiners C. [Differential diagnosis of the low echo thyroid nodule].  Dtsch Med Wochenschr. 1982;  107 1972-1975
    PubMedGoogle Scholar
  • 64 Wiedemann W, Baum K, Reiners C, Borner W. [Possibilities and limits of thyroid sonography in the diagnosis of thyroid cancer].  ROFO Fortschr Geb Rontgenstr Nuklearmed. 1982;  137 247-254
    PubMedGoogle Scholar
  • 65 Bauch K. et al . [Value of sonography in assessing nodular changes of the thyroid in an endemic goiter area].  Z Gesamte Inn Med. 1986;  41 542-547
    PubMedGoogle Scholar
  • 66 Drozd V, Polyanskaya O, Ostapenko V, Demidchik Y, Biko I, Reiners C. Systematic ultrasound screening as a significant tool for early detection of thyroid carcinoma in Belarus.  J Pediatr Endocrinol Metab. 2002;  15 979-984
    PubMedGoogle Scholar
  • 67 Gorman B. et al . Medullary thyroid carcinoma: role of high-resolution US.  Radiology. 1987;  162 147-150
    PubMedGoogle Scholar
  • 68 Kebebew E, Kikuchi S, Duh Q Y, Clark O H. Long-term results of reoperation and localizing studies in patients with persistent or recurrent medullary thyroid cancer.  Arch Surg. 2000;  135 895-901
    PubMedGoogle Scholar
  • 69 Kujat C, Muller-Leisse C, Falk S, Adam W, Pfannenstiel P. [Diagnosis of medullary thyroid gland carcinoma].  Dtsch Med Wochenschr. 1990;  115 1475-1479
    PubMedGoogle Scholar
  • 70 Peccin S, de Castsro J A, Furlanetto T W, Furtado A P, Brasil B A, Czepielewski M A. Ultrasonography: is it useful in the diagnosis of cancer in thyroid nodules?.  J Endocrinol Invest. 2002;  25 39-43
    PubMedGoogle Scholar
  • 71 Swaenepoel L, Demeester-Mirkine N, Sacre R, Jonckheer M H, van Geertruyden J. Ultrasound examination of the thyroid.  ROFO Fortschr Geb Rontgenstr Nuklearmed. 1982;  137 12-17
    PubMedGoogle Scholar
  • 72 Spiezia S, Cerbone G, Colao A, Assanti A P, Picone G M, Lombardi G. Usefulness of power Doppler in the diagnostic management of hypoechoic thyroid nodules.  Eur J Ultrasound. 1997;  6 165-170
    CrossrefPubMedGoogle Scholar
  • 73 Spiezia S, Cerbone G, Assanti A P, Colao A, Siciliani M, Lombardi G. Power Doppler ultrasonographic assistance in percutaneous ethanol injection of autonomously functioning thyroid nodules.  J Ultrasound Med. 2000;  19 39-46
    PubMedGoogle Scholar
  • 74 Chammas M C. et al . Thyroid nodules: evaluation with power Doppler and duplex Doppler ultrasound.  Otolaryngol Head Neck Surg. 2005;  132 874-882
    CrossrefPubMedGoogle Scholar
  • 75 Amodio F. et al . [An update of B-mode echography in the characterization of nodular thyroid diseases. An echographic study comparing 7.5 and 13 MHz probes].  Radiol Med (Torino). 1999;  98 178-182
    PubMedGoogle Scholar
  • 76 Chan B K, Desser T S, McDougall I R, Weigel R J, Jeffrey Jr R B. Common and uncommon sonographic features of papillary thyroid carcinoma.  J Ultrasound Med. 2003;  22 1083-1090
    PubMedGoogle Scholar
  • 77 Iannuccilli J D, Cronan J J, Monchik J M. Risk for malignancy of thyroid nodules as assessed by sonographic criteria: the need for biopsy.  J Ultrasound Med. 2004;  23 1455-1464
    CrossrefPubMedGoogle Scholar
  • 78 Papini E. 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
  • 79 Fukunari N, Nagahama M, Sugino K, Mimura T, Ito K, Ito K. Clinical evaluation of color Doppler imaging for the differential diagnosis of thyroid follicular lesions.  World J Surg. 2004;  28 1261-1265
    CrossrefPubMedGoogle Scholar
  • 80 Lyshchik A. et al . Thyroid gland tumor diagnosis at US elastography.  Radiology. 2005;  237 202-211
    CrossrefPubMedGoogle Scholar
  • 81 Argalia G. et al . [Echo Doppler in the characterization of thyroid nodular disease].  Radiol Med (Torino). 1995;  89 651-657
    PubMedGoogle Scholar
  • 82 Argalia G. et al . Ultrasonographic contrast agent: evaluation of time-intensity curves in the characterisation of solitary thyroid nodules.  Radiol Med (Torino). 2002;  103 407-413
    PubMedGoogle Scholar
  • 83 Garra B S. et al . Elastography of breast lesions: initial clinical results.  Radiology. 1997;  202 79-86
    CrossrefPubMedGoogle Scholar
  • 84 Cochlin D L, Ganatra R H, Griffiths D F. Elastography in the detection of prostatic cancer.  Clin Radiol. 2002;  57 1014-1020
    CrossrefPubMedGoogle Scholar
  • 85 Dietlein M. et al . Guideline for in vivo- and in vitro procedures for thyroid diseases.  Nuklearmedizin. 2003;  42 109-115
    PubMedGoogle Scholar

Prof. Dr. C. F. Dietrich

Innere Medizin 2 · Caritaskrankenhaus Bad Mergentheim

Uhlandstr. 7

97980 Bad Mergentheim

Phone: 49/79 31/58 22 01

Fax: 49/79 31/58 22 90

Email: Christoph.dietrich@ckbm.de

      >