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Der Klinikarzt 2019; 48(12): 521-530
DOI: 10.1055/a-1067-2589
Schwerpunkt
© Georg Thieme Verlag Stuttgart · New York

Wie werden Schilddrüsenknoten diagnostiziert?

Einsatz verschiedener diagnostischer Methoden
Friederike Eilsberger
1   Klinik für Nuklearmedizin, Universitätsklinikum Marburg, Marburg
,
Damiano Librizzi
1   Klinik für Nuklearmedizin, Universitätsklinikum Marburg, Marburg
,
Giulia Metzger
1   Klinik für Nuklearmedizin, Universitätsklinikum Marburg, Marburg
,
Markus Luster
1   Klinik für Nuklearmedizin, Universitätsklinikum Marburg, Marburg
,
Andreas Pfestroff
1   Klinik für Nuklearmedizin, Universitätsklinikum Marburg, Marburg
› Author Affiliations
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Publication History

Publication Date:
07 January 2020 (online)

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ZUSAMMENFASSUNG

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

 

  • Literatur

  • 1 Reiners C, Schumm-Draeger PM, Geling M. et al [Thyroid gland ultrasound screening (Papillon Initiative). Report of 15 incidentally detected thyroid cancers]. Internist (Berl) 2003; 44: 412-419
    CrossrefPubMedGoogle Scholar
  • 2 Völzke H, Lüdemann J, Robinson DM. et al The prevalence of undiagnosed thyroid disorders in a previously iodine-deficient area. Thyroid 2003; 13: 803-810
    CrossrefPubMedGoogle Scholar
  • 3 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
  • 4 Wiest PW. Thyroid palpation versus high-resolution thyroid ultrasonography in the detection of nodules. J Ultrasound Med 1998; 17: 487-496
    CrossrefPubMedGoogle 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 DGN-Handlungsempfehlung (S1-Leitlinie) Schilddrüsenszintigraphie (Version 4). Stand:10/2014, AWMF-Registrieringsnummer: 031–011
    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. et al 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
    CrossrefPubMedGoogle 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 1 1-43
    PubMedGoogle 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: 228-223
    Article in Thieme ConnectPubMedGoogle Scholar
  • 20 Friedrich-Rust M, Sperber A, Holzer K. et al Real-time elastography and contrast-enhanced ultrasound for the assessment of thyroid nodules. Exp Clin Endocrinol Diabetes 2010; 118: 602-609
    Article in Thieme ConnectPubMedGoogle Scholar
  • 21 Russ G, Bonnema SJ, Erdogan MF. et al European Thyroid Association Guidelines for Ultrasound Malignancy Risk Stratification of Thyroid Nodules in Adults: The EU-TIRADS. Eur Thyroid J 2017; 6: 225-237
    CrossrefPubMedGoogle Scholar
  • 22 Cibas ES, Ali SZ. The 2017 Bethesda System for Reporting Thyroid Cytopathology. Thyroid 2017; 27: 1341-1346
    CrossrefPubMedGoogle Scholar
  • 23 Seo JY, Park JH, Pyo JY. et al A Multi-institutional Study of Prevalence and Clinicopathologic Features of NON-invasive Follicular Thyroid Neoplasm with Papillary-like Nuclear Features (NIFTP) in Korea. J Pathol Transl Med 2019 Oct 21, doi: 10.4132/jptm.2019.09.18. [Epub]
    PubMedGoogle Scholar
  • 24 Suh CH, Choi YJ, Baek JH. et al The diagnostic performance of shear wave elastography for malignant cervical lymph nodes: A systematic reviwe and meta-analysis. Eur Radiol 2017; 27: 222-230
    CrossrefPubMedGoogle Scholar
  • 25 Frank-Raue K, Schott M, Raue F. Empfehlung zum Calcitonin-Screening bei Struma nodosa. Dtsch med Wochenschr 2018; 143: 1065-1069
    Article in Thieme ConnectPubMedGoogle Scholar