Ultrazvuk u dijagnostici tumora štitnjače

master's thesis

• Title (english): Ultrasound in diagnosis of thyroid tumors
• Author: Dragana Lukić
• Mentor: Gordana Ivanac (mentor)
• Committee member: Boris Brkljačić (predsjednik povjerenstva)
• Committee member: Milan Radoš (član povjerenstva)
• Committee member: Gordana Ivanac (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Radiology); Zagreb
• Defense date and country: 2017-07-14, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Radiology

Abstract

Štitnjača je žlijezda endokrinog sustava koja izlučuje hormone tirjoditironin (T3) i tiroksin (T4). Glavna je žlijezda ljudskog tijela s ulogom reguliranja metabolizma dok promjene u njenoj funkciji dovode do narušavanja homeostaze organizma. Većina patoloških procesa unutar tkiva štitnjače se očituju kao čvorovi. Učestalost čvorova štitnjače iznosi 50% u ukupnoj populaciji. Od svih čvorova štitnjače, velika većina je benignog karaktera. Najčešće benigne promjene štitnjače su multinodozna guša i adenomi štitnjače. Samo 4% svih čvorova štitnjače su maligni. Najčešći maligni tumori štitnjače su karcinomi, od kojih je najučestaliji papilarni karcinom koji čini 85% svih malignih tumora ove žlijezde. Slijede ga rijeđi karcinomi: folikularni karcinom, anaplastični karcinom i medularni karcinom.Za dijagnostiku čvorova štitnjače koristimo, uz klinički pregled, ultrazvuk i biopsiju tankom iglom. Ultrazvuk je izuzetno osjetljiva metoda koja otkriva čvorove štitnjače, s točnošću otkrivanja jednakoj postmortalnoj obdukciji. S povećanom uporabom ultrazvuka povećala se i incidencija otkrivanja čvorova štitnjače. Ultrazvučnim karakteristikama se koristimo za razlikovanje malignih od benignih promjena te za odluku o daljnjem liječenju pacijenata. Sve ultrazvučne karakteristike čvorova štitnjače pokazuju određenu osjetljivost, odnosno specifičnost. Od svih prediktora malignosti hipoehogenost ima osjetljivost 85%, odnosno specifičnost 70%; markirana hipoehogenost 94,3% i 26,5%; odsutnost haloa 26% i 69%; nepravilnost rubova i mikrolobulacije 55,1% i 83%; oblik viši nego širi 40% i 91,4%; mikrokalcifikacije 26% i 44-95%; stupnjevi vaskularizacije 3 i 4 zajedno 90% i 68%; te vaskularizacija 3 stupnja 60% i 100%. Što se tiče prediktora benignosti izoehogenost ima osjetljivost 68%, odnosno specifičnost 85%; vaskularizacija stupnja 1 i 2 zajedno 68% i 90%; vaskularizacija stupnjeva 1, 2 i 3 zajedno 100% i 60%.

Abstract (english)

The thyroid gland is an endocrine gland that releases triiodothyronine (T3) and thyroxine (T4) hormones. It is the main gland that regulates metabolism of the human body. Disturbance in its functioning results in impairment of normal functions of the body. The pathological processes within the thyroid tissue are most commonly manifested as nodules. The frequency of thyroid nodules in general population is 50%. Of all the thyroid nodules, the vast majority are benign in character. The most common benign thyroid changes are multinodular goiter and thyroid adenomas. Of all thyroid nodules, 4% are malignant. The most common malignant thyroid tumors are cancers, of which papillary cancer is the most frequent, accounting for 85% of all tumors. Less common are follicular carcinoma, anaplastic carcinoma and medullary carcinoma. Besides clinical examination, ultrasonography and fine needle aspiration biopsy are used for the diagnosis of thyroid nodules. Ultrasound is an extremely sensitive method for detection of thyroid nodules, with the diagnostic accuracy of postmortal autopsy. With increased use of ultrasound, the incidence of detection of thyroid nodules has increased. Ultrasound characteristics are used to distinguish between malignant and benign changes, and to decide on further treatment. All ultrasonic features of the thyroid nodules show certain sensitivity and specificity. As a predictor of malignancy hypoechogenicity has sensitivity of 85% and specificity of 70%; marked hypoechogenicity 94.3% and 26.5%; halo absence 26% and 69%; marginal irregularity and microlobulation 55.1% and 83%; shape taller-than-wide 40% and 91.4%; microcalcification 26% and 44-95%; vascularisation grades 3 and 4 together 90% and 68%; vascularisaton grade 3 60% and 100%, respectively. As a predictor of benignity isoechogenicity has sensitivity of 68% and specificity of 85%; vascularisation grades 1 and 2 together 68% and 90%; vascularisaton grades 1, 2 and 3 together 100% and 60% respectively.

• Keywords: štitnjača; čvorovi štitnjače; ultrazvuk; prediktori malignosti; prediktori benignosti
• Keywords (english): thyroid gland; thyroid nodules; ultrasound; malignant predictors; benign predictors
• Language: croatian
• URN:NBN: urn:nbn:hr:105:703261
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2018-03-21 10:29:07