Different patients come to me every day for their thyroid ultrasound. Some patients suffer from thyroid swelling, while others have undergone relevant examinations and been told that their thyroid gland has an impact and may require thyroidectomy.
In fact, it is very common to have a shadow on the thyroid gland, or it is called a nodule. Books on ultrasound have generally stated how common it is, that is, "your age plus a percentage" is the chance of having thyroid nodules in your age group. For example, if you are 50 years old this year, you have a 50% chance of developing thyroid nodules.
Thyroid nodules can be benign or malignant. Most thyroid nodules are benign. Only* less than 10% of thyroid nodules are malignant tumors.
There are two most important tests to diagnose whether a thyroid nodule is benign or malignant.
[The first step of examination: Ultrasound examination]
The first step is an ultrasound. Ultrasound can determine whether a thyroid nodule belongs to the low suspicion type or the high suspicion type based on its various characteristics, including its 1. composition, 2. echo, 3. ratio of height to width, 4. edge, and 5. whether there are high echo spots. The high suspicion category means that there is a relatively high chance that a certain thyroid nodule is a malignant tumor.
After using thyroid ultrasound to determine the characteristics of a thyroid nodule, you can know which thyroid nodule has a higher chance of malignancy.
[The second step of examination: fine needle cell examination]
Small needle cytology is the second diagnostic step for these higher suspicion thyroid nodules. Fine-needle cell aspiration under ultrasound guidance is the safest and most accurate method, and its accuracy can be as high as 90%. The needle usually used for this procedure is about the same thickness as the needle used to draw blood, or a little smaller, so it won't cause too much pain. Because this examination is not very painful, it is generally not necessary to use local anesthesia. A patient once told me that this small needle cell test is less painful than blood drawing. If the result of the small needle cell test is benign, it is still possible that the small needle did not pick up malignant cells, so regular ultrasound re-examination is still required for follow-up. If there is clinical suspicion, a repeat cell test must be performed. If the result of the small needle cytology test is malignant, you will need to discuss with the surgeon about the course of treatment.
According to a white paper published by the American College of Radiology in 2017, generally, if the size of thyroid nodules is less than one centimeter, small needle aspiration examination is not required. These nodules simply require periodic ultrasound examinations based on the category of his suspicion.
In summary, if you know you have thyroid nodules, don’t worry too much. What you need to do is to discuss with your doctor, conduct an ultrasound examination to classify the nodules, perform a small acupuncture examination if necessary, and then make a corresponding medical plan based on the acupuncture results.
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