RESUMO
Ultrasonography and scintigraphy are the first line diagnostic imaging modalities for the evaluation of thyroid nodules. Scintigraphy provides functional informations, mainly detection of hot nodules. US provides accurate morphologic evaluation and it may sometimes suggest malignancy. US is the modality of choice for follow-up of non resected nodules and is very useful for guidance during biopsy. CT and MRI are mainly used for preoperative evaluation of thyroid nodules.
Assuntos
Diagnóstico por Imagem , Nódulo da Glândula Tireoide/diagnóstico , Biópsia por Agulha , Seguimentos , Humanos , Imageamento por Ressonância Magnética , Cintilografia , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Ultrassonografia Doppler , Ultrassonografia de IntervençãoRESUMO
Ultrasonography (US) has become the gold standard of the preoperative detection of parathyroid masses. Provided that it is performed by sonographists aware of the normal and pathological anatomy of the neck, US can detect more than 80 per cent of the parathyroid masses. Ectopic masses, especially when they are intramediastinal, are rare but their diagnoses rely on more sophisticated procedures such as TI-Tc scintigraphy, CT, arteriography, MR, superselective venoius sampling. The specialized surgeons emphasize the lack of reliability of parathyroid US because of its operator-dependance. However, the accuracy of the technique enables some new treatments, percutaneous alcoolization and focal surgery under local anesthesia. One can regret that US is too often used as a diagnostic criterion of hyperparathyroidism, but this trend is explainable because of the difficulty to interpret monosymptomatic hypercalcaemia, especially in the elderly. The contribution of diagnostic imaging is undoubtfully worthwhile in persisting or recurrent hyperparathyroidisms, which are more often related with intracervical masses than with intramediastinal ones.