甲状腺结节的综合诊断
Luca Giovanella1,2, Alfredo Campennì3, Murat Tuncel4
1Department of Nuclear Medicine, Gruppo Ospedaliero Moncucco SA, Clinica Moncucco, 6900 Lugano, Switzerland.
Cancers
|January 23, 2024
概括
这篇评论讨论了甲状腺结节的诊断工具,包括超声波,光学图和细针吸收. 它建议将这些方法整合起来,以提高准确性,减少对甲状腺癌的不必要手术.
科学领域:
- 内分泌学 在内分泌学.
- 诊断成像 诊断成像 诊断成像
- 在瘤学瘤学.
背景情况:
- 甲状腺结节很普遍,特别是在缺的地区.
- 准确的诊断对于适当的患者管理至关重要.
- 目前的诊断工具有局限性,导致潜在的过度治疗或延迟诊断.
研究的目的:
- 审查和比较甲状腺结节的各种诊断工具.
- 为这些工具提出一个合理的整合战略.
- 突出方法,以减少不必要的手术为不确定的甲状腺结节.
主要方法:
- 甲状腺超声波 (美国) 和其评分系统的全面审查.
- 评估甲状腺扫描对高功能结节的评估.
- 细针吸入细胞学 (FNAC) 的分析及其不确定率.
- 在诊断中对分子成像 ([99mTc]Tc-MIBI, [18F]FDG) 和人工智能 (AI) 的评估.
主要成果:
- 超声波计分有助于区分良性与恶性结节.
- 甲状腺光学扫描有效地识别高功能结节,不包括恶性瘤.
- 不确定的FNAC结果需要进一步调查,通常是手术.
- [99mTc]Tc-MIBI和[18F]FDG分子成像显示有望避免不必要的手术.
结论:
- 以美国风险分层为指导的诊断工具的合理整合是必不可少的.
- 甲状腺扫描是高功能结节的关键,而美国指导FNAC用于非有毒结节.
- 分子成像和人工智能有可能提高诊断准确度,减少甲状腺结节的手术干预.
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