Gaosong Wu - Pitfalls in Ultrasound of Thyroid Nodules

Jointly published with China Science and Technology Press

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From the perspective of surgeons, more than 50 cases diagnosed with clinically common typical thyroid nodules were specially selected. Common misdiagnosed cases and part of difficult cases in the ultrasound diagnosis of thyroid nodules were covered. Each case was systematically introduced as follows: clinical data, ultrasound data, ultrasound evaluation preoperatively, gross specimen and pathological diagnosis, discussion: pitfalls and causes analyses. Thyroid nodules were deeply multi-dimensional interpreted by means of ultrasound images and video, specimen dissection and pathological examination, the causes of misdiagnoses were analyzed as well. This book was written uniquely with great practicability and multiple pictures, which had guiding significance for thyroid surgeons and ultrasound experts.

Thyroid is a superficial glandular tissue with uniform texture; ultrasound is the preferred method of examination for thyroid disease. Detecting thyroid nodules by ultrasound is very sensitive; 23 mm thyroid nodules can be detected. The detection rate of thyroid nodules is 1968%; 715% were malignant. The detection rate of unpalpable thyroid nodules is 5060% in persons more than 60 years old. The main purpose of ultrasound diagnosis is to distinguish benign and malignant nodules. Under the guidance of ultrasound, fine needle aspiration cytology can be performed for thyroid nodules with malignant signs, avoiding over treatment for benign thyroid nodules, saving precious medical resources, and avoiding morbidity. Ultrasonography is an important tool for thyroid surgeons in the diagnosis and treatment of thyroid nodules, playing an important role in assisting preoperative diagnosis and treatment. A suitable ultrasound diagnosis book helps surgeons to better carry out clinical work, making up for the lack of knowledge in anatomy and clinical pathology for ultrasound imaging physicians. Thyroid nodules can be diagnosed by dynamic ultrasound images of different sections collected by surgeons, requiring a relatively high level of skills of the sonographer. Misdiagnosis of thyroid nodules might occur owing to the evaluation by different physicians and instrument utilization. Benign nodules might be misdiagnosed as malignant nodules to be overtreated, or the malignant nodules might be missed or underdiagnosed.

This is the first book which has systematically summarized the ultrasound thyroid nodules from the perspective of surgeons, closely combining the imaging and clinical characteristics. During the clinical practice in our country, effective contact and communication lack between ultrasound imaging physician, pathology physician and surgeons. The surgeons act as a bridge, asking history preoperatively, combined with ultrasound diagnosis, observing the texture of nodules intraoperatively, confirming the ultrasound diagnosis by pathological examination postoperatively. Preoperative ultrasound evaluation can be detected by surgeons to decrease the missed and misdiagnosed nodules, improving the coincidence rate of ultrasound and pathological diagnosis. Department of Thyroid and Breast Surgery in Wuhan University Zhongnan Hospital accumulated multiple experience in the diagnosis of malignant thyroid nodules. This book contains abundant clinical cases and can be used as a teaching book for beginner and an expert-led training course.

Thanks for the assistance of Jinxuan Hou, Jiuyang Liu, Qianqian Yuan, Lewei Zheng during the book editing.