Thyroid nodules are a common clinical problem. They are usually detected by doctors during physical examinations or by people around them in their daily work. Five percent ~
7% have thyroid nodules. The chance of finding a thyroid nodule that cannot be felt by hand is higher when examined with ultrasound, reaching 50% in people over 50 years of age. Causes of high prevalence of thyroid nodules Excessive or low iodine intake, consumption of goiter-causing substances, consumption of goiter-causing drugs or defective thyroid hormone synthesis can lead to hyperplastic nodular goiter, while radiation exposure is one of the causative factors of thyroid cancer. Some viral or bacterial infections can lead to the development of inflammatory nodules. Due to the increasing concern of thyroid nodules, especially the continuous application of ultrasound technology, thyroid nodules have become highly prevalent in recent years. 1. Diagnosis of thyroid nodules The key to the diagnosis of thyroid nodules is to distinguish between benign and malignant. The diagnosis of thyroid nodules relies on history and physical examination, ultrasound, nuclear medicine nuclide scan, thyroid function test (blood test) and fine-needle aspiration cytology (FNAC).
aspiration cytology,
FNAC has brought about fundamental changes in the management of thyroid nodules and is the most valuable method for determining the benignity and malignancy of nodules, and is the greatest advance in thyroid surgery in the past 50 years. In the last 20 years or so, it has become a routine test for thyroid nodules abroad. Fine needle aspiration of thyroid nodules – the “gold standard” for thyroid nodule diagnosis Fine needle aspiration cytology (FNAB) of thyroid nodules is considered to be the most predictive technique before surgery and has become the standard procedure for the treatment of thyroid nodules because it is less invasive, faster and more accurate. It has become a standard procedure in the treatment of thyroid nodules because it is less invasive, rapid and accurate. FNAB performed by an experienced examiner has a specificity of 92% (72-100%) and a false positive rate of 5% (0-7%). 2. Treatment of thyroid nodules The greatest advantage of surgical resection is the achievement of an aneurysmal thyroid gland, but the disadvantages are also evident. Normal glands are removed at the same time, long-lasting hoarseness due to damage to the recurrent laryngeal nerve, hypoparathyroidism due to parathyroid miscutting, and aesthetic or restricted movement of the neck in patients with scarring have become a problem for the majority of operators. Patients with thyroid nodules may opt for minimally invasive ablation. Traditional thyroid (lobectomy), lumpectomy-assisted small incision thyroidectomy, lumpectomy thyroidectomy and percutaneous thermal ablation of thyroid nodules are available for treatment of thyroid nodules that meet the indications. Percutaneous thermal ablation of thyroid nodules is a new method of thyroid nodule treatment developed in China in recent years. Through ultrasound guidance, radiofrequency/microwave/laser ablation needles are inserted into the nodules percutaneously and precisely for ablation, and the high temperature generated by the ablation needles makes the cell activity disappear completely, achieving similar effects as traditional surgery, with the advantages of small trauma, no scars and maximum preservation of thyroid function, which is a good complement to traditional open surgery. 3.Thyroid nodule ablation Indications for thyroid nodule ablation surgery: 1.Benign thyroid nodules: thyroid adenoma, nodular goiter, thyroid cyst (including post-operative recurrence) 2.Malignant nodules: thyroid cancer not suitable for surgical removal, recurrent thyroid cancer, metastatic lesions in the lymph nodes of the neck. Thyroid nodule diagnosis and treatment: comprehensive treatment and standardized treatment are needed The treatment of thyroid nodules involves many disciplines such as thyroid surgery, endocrinology, nuclear medicine, pathology, and imaging intervention.