The optimal diagnostic complex in the surgical treatment of nodular euthyroid goiter

Abstract

Different methods for preoperative diagnosis of nodular euthyroid formations of the thyroid gland are compared. The sensitivity and specificity of ultrasonic examination (based on the study of the semeiotics of nodular formations of the thyroid), fine-needle aspiration biopsy (under palpation and ultrasonic control), and complex diagnosis (simultaneous assessment of ultrasonic semeiotics of the nodular formation and controlled biopsy under ultrasonic control followed by cytological examination of puncture biopsy specimens) are assessed. With this aim in view, 342 patients with nodular euthyroid formations were examine^ in 1994-1996. Benign nodular formations were detected in 316 (92.4%)) and thyroid cancer in 26 (7.6%o) patients. In the group with benign formations, colloid goiter was diagnosed in 204 (59.7%), follicular-cell adenomas in 78 (22.8%)), and hypertrophic autoimmune thyroiditis in 34 (9.9%) cases. The authors consider that ultrasonic examination combined with fine-needle aspiration biopsy is the most available, safe, and highly effective complex for the diagnosis of nodular euthyroid formations at the preoperative stage. Complex preoperative ultrasonic examination with fine-needle biopsy help single out the group with suspected malignant involvement of the thyroid with a high probability. Use of this complex and intraoperative ultrasonic examination correctly identified the type of thyroid involvement and its morphology in 92.4%o of cases, and thus helped choose adequate volume of intervention.