The value of sonography in thyroid diagnostics

Since the introduction of the gray scale-technique, sonography has gained a definitive position in thyroid diagnostics. Sonography should be combined with scintigraphy and fine needle-aspiration biopsy according to the underlaying thyroid disease. As a rule, a combination of sonography and scintigraphy is recommended for basic thyroid examinations, except for cases of normally sized thyroid glands, pregnancy or young patients. Follow-up examinations should be based on sonography alone, unless autonomy is suspected, which should be examined by suppressive scintigraphy during thyroid hormone therapy. After surgery or radio-iodine therapy, the follow-up should be based on both scintigraphy and sonography. Metastases of thyroid malignancies always have to be examined for their radio-iodine uptake. The positive effects of sonography suitably combined with scintigraphy and fine needle-aspiration biopsy have been reflected in the decreasing number of indications for surgical intervention in our patients with nodular goitres. (orig.)