Abstract：
From low-resolution images in the 1960s to current high-resolution technology, ultrasound has proven to be the initial imaging modality of choice for thyroid application. Point-of-care ultrasound has brought the technology to the thyroid specialist. Combined with physical examination, it provides real-time information regarding goiter, thyroid nodules, and thyroid cancer. Ultrasound-guided fine-needle aspiration biopsy has become the accepted norm, with biopsies rarely performed using palpation alone. Advantages of ultrasound-guided biopsy include precise placement of the needle within the nodule, selective sampling of areas with suspicious features, and accurate direction of the biopsy needle to actively growing viable cells in the periphery of the nodule. Education of endocrinologists in thyroid ultrasound began in the late 1990s and by 2016 more than 6000 clinicians had completed an ultrasound course. Concurrent with this rapid expansion of use of thyroid ultrasound was a rise in the diagnosis of small papillary carcinomas, which might have otherwise remained indolent and undetected. The 2009 American Thyroid Association Guidelines for the Management of Thyroid Nodules and Thyroid Cancer recommended biopsy for all solid hypoechoic nodules measuring larger than 1 cm. Attempting to decrease the frequency of biopsies of low-risk nodules, subsequent guidelines have focused on identifying and selectively biopsying those thyroid nodules at higher risk of clinically significant carcinoma based on ultrasound appearance. A major role for thyroid ultrasound has been in both preoperative staging and mapping to help determine the extent of surgery, as well as postoperative monitoring for locoregional soft tissue or lymph node metastases. With the recognition that the increase in papillary carcinoma was predominantly a result of early diagnosis of small often indolent cancers, active surveillance has become a promising management strategy for papillary thyroid microcarcinomas. Thyroid ultrasound is essential to active surveillance of thyroid cancer. Easy access to high-quality ultrasound studies is a requirement for a successful active surveillance program. Thyroid ultrasound has been used to facilitate interventional procedures, including treatment of thyroid nodules, treatment of recurrent thyroid cancer, and therapy of papillary thyroid microcarcinoma.
摘要：
从20世纪60年代的低分辨率图像到现在的高分辨率技术，超声已被证明是甲状腺应用的首选成像方式。即时超声为甲状腺专家带来了这项技术。结合体检,它提供有关甲状腺肿的实时信息，甲状腺结节,和甲状腺癌。超声引导下细针穿刺活检已成为公认的标准,很少单独使用触诊进行活检。超声引导活检的优点包括将针精确放置在结节内，对具有可疑特征的区域进行选择性采样，以及活检针的准确方向，以在结节周围积极生长活细胞。对甲状腺超声内分泌学家的教育始于1990年代后期，到2016年，已有6000多名临床医生完成了超声课程。同时，甲状腺超声的使用迅速扩大是小乳头状癌的诊断上升，否则它们可能会保持惰性和未被发现。2009年美国甲状腺协会甲状腺结节和甲状腺癌治疗指南建议对所有大于1厘米的实性低回声结节进行活检。试图减少低风险结节的活检频率，随后的指南重点是根据超声外观识别和选择性活检那些具有较高临床意义的癌症风险的甲状腺结节.甲状腺超声的主要作用是在术前分期和标测，以帮助确定手术的范围，以及局部软组织或淋巴结转移的术后监测。认识到乳头状癌的增加主要是早期诊断为小的通常是惰性的癌症的结果，主动监测已成为甲状腺乳头状微小癌的一种有希望的治疗策略.甲状腺超声对甲状腺癌的积极监测至关重要。轻松获得高质量的超声研究是成功的主动监测计划的必要条件。甲状腺超声已用于促进介入程序，包括甲状腺结节的治疗,复发性甲状腺癌的治疗，甲状腺乳头状微小癌的治疗。
