PDF(Pubmed)
Abstract：
Benign thyroid nodules are significantly common and occur in 50-60% of the population. Therefore, differentiation from malignant nodes and the choice of treatment tactics in some cases of benign pathology remain relevant. Despite advances in the clinical evaluation of thyroid nodules, methodological challenges exist due to empirically simplistic understandings of the nodular process. Different opinions on the pathogenesis of thyroid nodules and the history of the formation of the idea of the stages of nodules are considered. For the first time, based on natural principles and many years of ultrasound analysis of changes in benign thyroid nodules, three stages of the nodular process were identified: Development, Wasting and Scarring. The stage of exhaustion has three substages: Initial, Moderate and Significant Wasting. The principles of stage-by-stage changes in nodules are explained and their ultrasound signs are shown. The key principle of the stages of nodules is the ratio of the magnitudes of the processes of regeneration (proliferation) and destruction in the nodule. Separate stage changes may occur in node segments. In such cases, part of the segments may show signs of the Development stage, another part-Wasting, and the third part-Scarring. The different variants of thyroid nodules are explained in terms of stages. Practical recommendations for differentiating ultrasound signs of nodules associated with stages are proposed. Knowledge about the staged changes in thyroid nodules helps reduce the likelihood of diagnostic errors, better navigate the prognosis and choice of treatment tactics, and recommend preventive ultrasound examination of the thyroid.
摘要：
良性甲状腺结节非常常见，发生在50-60％的人群中。因此,在某些良性病理病例中，与恶性淋巴结的区别和治疗策略的选择仍然相关。尽管甲状腺结节的临床评估取得了进展，由于对结节过程的经验简单化理解，存在方法论上的挑战。对甲状腺结节的发病机制和结节分期形成思想的历史有不同的看法。第一次,根据自然原理和多年的超声分析甲状腺良性结节的变化，确定了结节过程的三个阶段：发展，浪费和疤痕。精疲力竭阶段有三个子阶段：初始阶段，适度和显著的浪费。解释了结节逐级变化的原理，并显示了它们的超声征象。结节阶段的关键原则是结节中再生（增殖）和破坏过程的幅度之比。在节点段中可能发生单独的阶段变化。在这种情况下,部分细分市场可能显示出发展阶段的迹象，另一部分——浪费，和第三部分——疤痕。甲状腺结节的不同变体按分期进行解释。提出了区分与分期相关的结节超声征象的实用建议。了解甲状腺结节的阶段性变化有助于减少诊断错误的可能性，更好地引导预后和治疗策略的选择，并建议对甲状腺进行预防性超声检查。
