There are more and more people around who have thyroid nodules. With the increasing technology of screening devices, 60-70% of Chinese people can detect thyroid nodules when the resolution of ultrasound reaches 1mm. This means that 2 out of 3 Chinese people have nodules. This makes it seem like thyroid nodules are not even a disease anymore.
We often hear about people who go for medical checkups and find out that they have multiple thyroid nodules. Whoever has a nodule in the thyroid gland that was detected during a physical examination at work has to undergo surgery. Yes, thyroid nodules are so painless and insidious. More and more people are suffering from thyroid nodules, does it matter or not?
Of thyroid nodules, 85-95% are benign nodules. Of the malignant thyroid nodules, more than 90% are low-grade malignant.
1. Is ultrasound or CT or MRI better to check the thyroid?
Ultrasound is the most accurate imaging test for the thyroid, but CT and MRI are not as good. Unless you want to see the details of the surrounding tissues, you can have another MRI.
2. How do I look at thyroid ultrasound results?
Ultrasound looks at 3 points: in order of weight: border – calcification – blood flow.
The following are some of the common descriptions on the report.
(1) “Poorly defined borders”.
Benign nodules generally have clear borders, and malignant ones because there is invasion of surrounding tissues. The borders can be unclear. However, inflammatory lesions, which are not malignant because they can be exudative, also have unclear borders.
(2) “Dotted strong echogenicity”.
It can be seen in two conditions: one is colloid, which is a sign of benign. One is calcification, malignant generally have calcification, and most of them are microcalcifications; however, having calcification is not necessarily malignant.
(2) “Internal blood flow disturbance”.
Blood flow is divided into internal blood flow and external blood flow. Malignant ones mostly have internal blood flow disturbances.
(1) Poorly defined borders.
(ii) Microcalcifications.
③Internal blood flow disorder.
If these 3 points are not present at all, there is no need to be concerned, as the possibility of benign is high. If you have 1-2 points, you should have a puncture, and if you have all 3 points, there is a high possibility of malignancy.
To identify benign and malignant nodules, in addition to the above three points, you can also look at: whether there are adhesions with the surrounding tissue, the presence of lymph node metastasis, whether the rapid increase in the short term, the growth pattern (longitudinal growth of malignant nodules is more likely), nodule size (nodules > 50px is also recommended for surgery) and so on.
3. What about benign nodules?
High TSH can cause thyroid nodules to grow, so people with nodules require a low TSH, between 0.5 and 1.0.
TSH has a feedback relationship with T3 and T4. High TSH can promote higher T3 and T4 levels; and higher T3 and T4 will in turn feed back to make TSH levels lower.
People with nodules should lower their TSH levels appropriately. What are the methods? The first choice is dietary therapy.
What foods shrink nodules?
Cruciferous foods: cabbage, white radish, etc., because they can make T3 and T4 synthesis blocked, thus elevating TSH, so it is long nodules, eat less, but is not contraindicated, after all, you can not eat too much a day.
Patients with thyroid nodules, as long as TpoAb, TgAb, TRAb these antibodies are negative, no need to avoid iodine; if TpoAb, TgAb, TRAb positive, it is necessary to eat less kelp, nori type high iodine food.
Benign nodules can be reviewed regularly by ultrasound. It is normal for the size of the nodule described on the result report to deviate by a few millimeters due to the difference in the ultrasound probe section each time. Although benign nodules can be treated with dietary therapy, there are no measures that can significantly reduce the size of nodules. There is no need to be demanding either. As long as benign nodules do not increase significantly, are not painful or itchy, do not affect thyroid function, do not compress surrounding tissues, and have no malignant tendency, there is no need to be too concerned at all. Zhang Xingguang, Department of Endocrinology, General Hospital of Beijing Military Region