{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T01:53:29Z","timestamp":1750902809208},"reference-count":74,"publisher":"Georg Thieme Verlag KG","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Laryngorhinootologie"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>\n            Hintergrund Die Elastografie ist eine bildgebende Methode, um die Elastizit\u00e4t von Gewebe zu untersuchen. Inzwischen wurden verschiedene Elastografie-Verfahren entwickelt, die nach der Art des angewandten Stimulus unterteilt werden. Prinzipiell ist zwischen der Strain-Elastografie (SE) und Scherwellen-Elastografie (SWE) zu unterscheiden. Beide Methoden bieten neben der konventionellen B-Mode-Sonografie eine weitere M\u00f6glichkeit zur Beurteilung von Schilddr\u00fcsenerkrankungen.<\/jats:p><jats:p>\n            Ziel der Arbeit Es soll ein \u00dcberblick \u00fcber die Elastografie-Verfahren einschlie\u00dflich der physikalischen Grundlagen vermittelt werden sowie ihre Bedeutung im Abkl\u00e4rungsalgorithmus von Schilddr\u00fcsenknoten.<\/jats:p><jats:p>\n            Material und Methoden Internationale Leitlinien sowie aktuelle Arbeiten zur Elastografie wurden selektiv recherchiert.<\/jats:p><jats:p>\n            Ergebnisse Die Elastografie liefert zus\u00e4tzliche Informationen gegen\u00fcber der konventionellen B-Mode-Sonografie. Der wesentliche physikalische Mechanismus, dem der Gewebekontrast in allen Elastogrammen zugrunde liegt, ist die \u00c4nderung der Schersteifigkeit. Neben der qualitativen Erfassung der Elastizit\u00e4t in der SE ist mit der SWE eine Quantifizierung m\u00f6glich. In der internationalen Literatur wurde die Elastografie als einzelne Methode oder im Vergleich bzw. in Kombination zur konventionellen B-Mode-Sonografie und insbesondere mit der Standardisierung mittels eines Risikostratifizierungssystems (RSS, TIRADS) analysiert. Die Ergebnisse zeigten sich durchaus kontrovers. Bei Knoten mit unklaren Befunden der Feinnadelbiopsie (Bethesda III\/IV) f\u00fchrte die Kombination aus morphologischen Kriterien und Elastografie zu einer Verbesserung der diagnostischen Genauigkeit. Insbesondere der hohe negative pr\u00e4diktive Wert weicher Knoten stellt einen relevanten Mehrwert dar. Diese St\u00e4rke der Methode kann bei der Abkl\u00e4rung von Knoten mit mittlerem Malignomrisiko oder von unklaren FNB-Ergebnissen eine wichtige Rolle spielen. Die Elastografie wurde bisher nur in das (\u00fcberwiegend durch das EU-TIRADS abgel\u00f6ste) French-TIRADS integriert. Obwohl das Verfahren im EU-TIRADS als Komplement\u00e4rmethode Erw\u00e4hnung findet, wurde eine Integration nicht beschrieben. Limitationen des Verfahrens sind idealisierte Grundannahmen, Hersteller- und Untersucherabh\u00e4ngigkeit sowie Artefakte.<\/jats:p><jats:p>\n            Schlussfolgerung Die Elastografie kann bei der Beurteilung von Schilddr\u00fcsenknoten die standardisierten Diagnostikverfahren sinnvoll erg\u00e4nzen, insbesondere bei Knoten mit mittlerem Malignomrisiko und unklaren Ergebnissen in der Feinnadelpunktion.<\/jats:p>","DOI":"10.1055\/a-2144-4176","type":"journal-article","created":{"date-parts":[[2023,11,2]],"date-time":"2023-11-02T23:30:36Z","timestamp":1698967836000},"page":"839-849","source":"Crossref","is-referenced-by-count":1,"title":["Elastografie von Schilddr\u00fcsenknoten"],"prefix":"10.1055","volume":"102","author":[{"given":"Manuela","family":"Petersen","sequence":"additional","affiliation":[{"name":"Arbeitsbereich Gef\u00e4\u00dfchirurgie, Klinik f\u00fcr Allgemein-, Viszeral-, Gef\u00e4\u00df- und Transplantationschirurgie, Universit\u00e4tsklinikum Magdeburg A.\u00f6.R., Magdeburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Burkhard","family":"Klemenz","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Nuklearmedizin, Bundeswehrkrankenhaus Ulm, Ulm, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simone A.","family":"Schenke","sequence":"additional","affiliation":[{"name":"Klinik und Institut f\u00fcr Nuklearmedizin, Klinikum Bayreuth GmbH, Bayreuth, Germany"},{"name":"Bereich Nuklearmedizin, Universit\u00e4tsklinik f\u00fcr Radiologie und Nuklearmedizin, Universit\u00e4tsklinikum Magdeburg,"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,11,2]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1152\/physiolgenomics.00158.2013","article-title":"The wound healing, chronic fibrosis, and cancer progression triad","volume":"46","author":"B Rybinski","year":"2014","journal-title":"Physiol 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