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Der Nuklearmediziner 2008; 31(3): 224-227
DOI: 10.1055/s-2008-1076794
Schilddrüsenknoten

© Georg Thieme Verlag Stuttgart ˙ New York

Der Schilddrüsenknoten – TSH und periphere Hormone

The Thyroid Nodule – Thyrotropin and peripheral Thyroid HormonesM. Zimny1
  • 1Institut für Nuklearmedizin, Klinikum Hanau
Further Information

Publication History

Publication Date:
10 September 2008 (online)

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Zusammenfassung

Thyreoidea-stimulierendes Hormon (TSH), freies Triiodthyronin (fT3) und Thyroxin (fT4) stellen die Basisparameter der Schilddrüsendiagnostik dar, die allerdings nur bei einem geringen Anteil der Patienten mit Schilddrüsenknoten pathologisch verändert sind. Neben einer Einführung in Regulation und Wirkprinzip der Schilddrüsenhormone sowie Auswirkungen einer subklinischen und manifesten Hyperthyreose, wird der Informationsgehalt dieser Basisparameter, der über die einfache Beschreibung der Stoffwechsellage hinaus geht, anhand von Literaturdaten und eigenen Beobachtungen diskutiert. Während die Höhe eines im Normbereich gelegenen TSH schon wichtige prädiktive Informationen über die funktionelle Relevanz autonomer Knoten und die Dignität hormoninaktiver Knoten liefern kann, gibt das Verhältnis der Schilddrüsenhormone zueinander Anhaltspunkte für die Genese einer Hyperthyreose. TSH ist darüber hinaus der entscheidende Parameter zur adäquaten Einstellung einer Hormonsubstitution bei der konservativen Therapie von Schilddrüsenknoten.

Abstract

Thyrotropin, free triodothyronine and thyroxine represent the standard serological parameters for the diagnostic work-up of the thyroid but only a minority of thyroid nodules present with subclinical or overt thyroid disorders. Besides a review of the regulation and principle of function of thyroid hormones as well as the effects of subclinical or overt hyperthyroidism, the significant role of these parameters beyond the assessment of hyperthyroidism in thyroid nodules is discussed. There is evidence that the level of thyrotropin within the normal range is predictive for the relevance of autonomous functioning nodules and the risk of malignancy of non-functioning thyroid nodules. Furthermore, the ratio of triodothyronine and thyroxine indicates the etiology of hyperthyroidism. Thyrotropin represents the main parameter to determine the adequate dose of thyroid hormone therapy of thyroid nodules.

Schlüsselwörter

Schilddrüsenknoten - TSH - Triiodthyronin - Thyroxin - Autonomie - Schilddrüsenkarzinom

Key words

thyroid nodule - thyrotropin - triiodothyronine - thyroxine - hyperthyroidism - malignancy

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PD Dr. M. Zimny

Institut für Nuklearmedizin · Klinikum Hanau

Leimenstr. 20

63450 Hanau

Phone: +49 / 61 81 / 9 22 11 50

Fax: +49 / 61 81 / 9 22 11 10

Email: zimny@nuklearmedizin-hanau.de

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