| Abstract | Ultrazvuk (UZ) je dijagnostička tehnika koja se često koristi u procjeni patologija vrata, posebno u vezi s štitnjačom, limfnim čvorovima, krvnim žilama i žlijezdama slinovnicama. Uspoređujući s CT-om, SPECT CT-om i MR-em, UZ je siguran i neinvazivan, ne koristi ionizirajuće zračenje i često je prva metoda koja se koristi u dijagnostici patologija vrata zbog svoje brze dostupnosti i niske cijene. Ultrazvuk je vrlo koristan u dijagnostici štitne žlijezde. Koristi se za procjenu gušavosti, daje podatke o veličini režnjeva njihovom eventualnom retrosternalom poniranju koji mogu otežati operativni zahvat, prisutnosti čvorova i sumnjivih nalaza. Ultrazvuk pruža dodatne informacije različitim patologijama štitnjače, kao što su Hashimotov tireoiditis, de Quervainov tireoiditis, cistični koloidni čvorovi, adenomi, papilarni karcinom, folikularni karcinom, medularni karcinom i anaplastični karcinom. Kod sumnje na malignitet, aspiracija tankom iglom se svakako preporučuje za dobivanje citološke analize, koja znatno doprinosi diferencijalno dijagnostici raznih nodularnih tvorbi. Ultrazvuk je i prva metoda pri procijeni povećanih limfnih čvorova vrata, te može pomoći u razlikovanju reaktivnih od drugih patoloških stanja, kao što su metastatski procesi i limfoproliferativna oboljenja. Kod suspektnih nodusa aspiracija tankom iglom nam daje vrlo korisne podatke, no kod limfoma ona ponekad nije dovoljna, te je za konačnu dijagnozu potrebna i biopsija. Ultrazvuk je koristan i za diferencijalnu dijagnozu patologije žlijezda slinovnica, od raznih sialadenitisa, sialolitijaze, ali i benignih i malignih tumora (pri čemu je svakako potrebna FNA). Ultrazvuk koristi i u procjeni aterosklerotskih lezija i aneurizmi karotida, a koristan je i u diferencijalnoj dijagnostici musculature vrata kao i subkutanog veziva i masnog tkiva. Iako nisu uvijek tipične svaka od ovih patologija ima neke ultrazvučne značajke koje mogu pomoći u diferencijalnoj dijagnozi. Svakako su nam od velike pomoći i podaci dobiveni citološkom analizom kada ultrazvučna slika nije dovoljna.
Nadamo se da će uz veću dostupnost i manje aparate ova tehnika biti sve češća u primarnoj zaštiti stoga bi njome trebao vladati svaki liječnik. |
| Abstract (english) | Ultrasound (US) is a diagnostic technique that is often used in the evaluation of neck pathologies, especially in relation to the thyroid gland, lymph nodes, blood vessels and salivary glands. Compared to CT, SPECT CT and MR, US is safe and non-invasive, does not use ionizing radiation and is often the first method used in the diagnosis of neck pathologies due to its rapid availability and low cost. Ultrasound is very useful in the diagnosis of the thyroid gland. It is used to assess goitre, it provides data on the size of the lobes, their possible retrosternal immersion that can make surgery difficult, the presence of nodes and suspicious findings. Ultrasound provides additional information on various thyroid pathologies, such as Hashimoto's thyroiditis, de Quervain's thyroiditis, cystic colloid nodules, adenomas, papillary carcinoma, follicular carcinoma, medullary carcinoma, and anaplastic carcinoma. When malignancy is suspected, aspiration with a fine needle is definitely recommended to obtain a cytological analysis, which significantly contributes to the differential diagnosis of various nodular formations. Ultrasound is the first method for evaluating enlarged lymph nodes in the neck, and can help distinguish reactive from other pathological conditions, such as metastatic processes and lymphoproliferative diseases. In the case of suspicious nodules, aspiration with a fine needle gives us very useful data, but in the case of lymphoma it is sometimes not enough, and a biopsy is also required for the final diagnosis. Ultrasound is also useful for the differential diagnosis of salivary gland pathology, from various sialadenitis, sialolithiasis, as well as benign and malignant tumors (where FNA is definitely required). Ultrasound is used in the assessment of atherosclerotic lesions and carotid aneurysms, and is also useful in the differential diagnosis of neck musculature as well as subcutaneous connective tissue and fat tissue. Although they are not always typical, each of these pathologies has some ultrasound features that can help in the differential diagnosis. The data obtained by cytological analysis are certainly of great help to us when the ultrasound image is not sufficient.
We hope that with greater availability and smaller devices, this technique will be more and more common in primary care, so every doctor should master it. |
