According to foreign literature, nodules in the thyroid gland can be detected by high-frequency ultrasound in 19%-67% of the normal population, and a very high percentage of thyroid nodules (benign nodules and malignant nodules) exist in the thyroid gland in autopsies. Epidemiological studies have found that benign nodules and differentiated papillary carcinomas (including papillary carcinomas and follicular carcinomas) can survive for a long time after standardized treatment and close follow-up, and a few cases with a high degree of malignancy can also survive with tumors for a long time. The most common clinical thyroid cancer is papillary carcinoma (about 85%-90%), which is a tumor with excellent prognosis and very slow progression, commonly known as inert tumor. Due to excessive propaganda by media and medical institutions, more and more people talk about cancer and once thyroid nodules are detected by examination, they will face a lot of confusion, such as
1. whether all thyroid nodules must be operated?
2. What kind of nodules are malignant nodules?
3. How big a nodule needs surgery?
4. Do all microscopic thyroid cancers require surgery?
5.Do patients with clinical suspicion of microscopic thyroid cancer need surgery immediately?
6.Is it necessary to terminate pregnancy for thyroid cancer in pregnancy?
7.What is the impact of total thyroidectomy on the quality of life (or health)?
8.Can I have a normal pregnancy and breastfeeding after thyroid cancer surgery?
9.What are the susceptibility factors of thyroid cancer (diet, environment, genetics)?
10.What is the strategy of long-term follow-up after thyroid cancer surgery?
This time, we will briefly discuss the common ultrasound features of malignant thyroid nodules and the key points of diagnosis and treatment of thyroid cancer.
I. Common ultrasound features of malignant nodules.
1, hypoechoic lesions (mostly papillary carcinoma), isoechoic or hyperechoic lesions (mostly follicular carcinoma).
2, poorly defined nodal borders.
3, longitudinal diameter of the nodule is larger than the transverse diameter.
4, small calcifications inside the nodule.
5, abundant blood flow within the nodule.
6, lack of a peripheral halo.
7, regional lymph node enlargement (with structural abnormalities, calcification, and cystic changes mostly suggesting lymph node metastasis).
II. Diagnostic points.
1, nodules with the above ultrasound features.
2. inexplicable voice changes (hoarseness).
3, physical examination: hard, poorly mobile thyroid nodules and enlarged lymph nodes in the neck.
4, fine needle aspiration cytology pathology suggesting malignancy.