{"id":341,"date":"2018-11-21T10:29:13","date_gmt":"2018-11-21T10:29:13","guid":{"rendered":"https:\/\/www.barnaclinic.com\/blog\/cirugia-de-tiroides\/ca\/?p=341"},"modified":"2018-11-21T10:29:13","modified_gmt":"2018-11-21T10:29:13","slug":"diagnostic-nodul-tiroidal-sistema-bethesda","status":"publish","type":"post","link":"https:\/\/www.barnaclinic.com\/blog\/cirugia-de-tiroides\/ca\/diagnostic-nodul-tiroidal-sistema-bethesda\/","title":{"rendered":"Diagn\u00f2stic del N\u00f2dul Tiro\u00efdal, la bi\u00f2psia i el Sistema Bethesda"},"content":{"rendered":"

Com hem explicat anteriorment,\u00a0l’Ecografia cervical<\/strong>\u00a0permet estratificar el\u00a0risc de malignitat del n\u00f2dul tiro\u00efdal<\/strong><\/a><\/span>\u00a0en funci\u00f3 de les caracter\u00edstiques ecogr\u00e0fiques, per\u00f2 aix\u00f2 no \u00e9s suficient per poder prendre una decisi\u00f3 respecte a indicar una intervenci\u00f3 quir\u00fargica.<\/span>\u00a0Un cop tenim una alta sospita de malignitat, el seg\u00fcent\u00a0pas terap\u00e8utic ha de ser la realitzaci\u00f3 d’una\u00a0bi\u00f2psia de teixit<\/strong>\u00a0per a la seva an\u00e0lisi i\u00a0classificaci\u00f3 mitjan\u00e7ant el\u00a0Sistema Bethesda<\/strong><\/a>.<\/span><\/p>\n

BI\u00d2PSIA PER PUNCI\u00d3 ASPIRACI\u00d3 AMB AGULLA FINA (PAAF)<\/strong><\/span><\/h2>\n

Per realitzar la bi\u00f2psia i obtenir el teixit necessari, avui dia, es practica una\u00a0Punci\u00f3 Aspirativa amb Agulla Fina\u00a0<\/strong>(PAAF)<\/a>.<\/span>\u00a0\u00c9s un procediment molt poc invasiu, realitzat de forma ambulat\u00f2ria i amb anest\u00e8sia local.<\/span>\u00a0Amb aquesta punci\u00f3 serem capa\u00e7os de caracteritzar el n\u00f2dul de forma gaireb\u00e9 exacta.<\/span><\/p>\n

EL SISTEMA BETHESDA, OBJECTIU I DE F\u00c0CIL INTERPRETACI\u00d3<\/strong><\/span><\/h2>\n

Un cop realitzada la bi\u00f2psia i processada i analitzada la mostra, obtindrem una informaci\u00f3 molt important per poder prendre decisions.<\/span>\u00a0Existeix una classificaci\u00f3 patol\u00f2gica anomenada\u00a0Sistema Bethesda<\/strong>\u00a0que, quan s’aplica adequadament, permet assignar un rang de probabilitats de malignitat a les mostres obtingudes.<\/span>\u00a0\u00c9s una escala que s’obt\u00e9 de la interpretaci\u00f3 de les diferents caracter\u00edstiques de les c\u00e8l\u00b7lules i el teixit obtinguts en la bi\u00f2psia i serveix per confirmar o no la\u00a0malignitat del\u00a0n\u00f2dul tiro\u00efdal<\/a><\/strong>.<\/span><\/p>\n

\n

\"Oscar-Vidal\"<\/strong><\/em><\/h4>\n

“El Sistema Bethesda \u00e9s una escala que s’obt\u00e9 de la interpretaci\u00f3 del teixit obtingut en la bi\u00f2psia i serveix per confirmar o no la malignitat del n\u00f2dul tiro\u00efdal”<\/strong><\/span><\/h4>\n

Dr. Oscar Vidal<\/a><\/p><\/blockquote>\n

COM INTERPRETAR EL SISTEMA BETHESDA?<\/strong><\/h2>\n

Despr\u00e9s d’analitzar la mostra de teixit obtingut de la bi\u00f2psia, el facultatiu emet un informe que cont\u00e9 un nombre (Rom\u00e0), que va de l’I al VI (pe Bethesda II), sent el nombre m\u00e9s gran, el que atorga m\u00e9s probabilitats de malignitat.<\/span>\u00a0Aquest sistema \u00e9s objectiu i fa que, independentment de l’hospital, ciutat o pa\u00eds d’origen de la mostra, la interpretaci\u00f3 dels resultats sigui senzilla.<\/strong><\/span> La\u00a0Asociaci\u00f3n Espa\u00f1ola de Cirujanos (AEC)<\/a>, la\u00a0Sociedad Espa\u00f1ola de Endocrinolog\u00eda y Nutrici\u00f3n (SEEN)<\/a>, i la\u00a0Associaci\u00f3 Americana del Tiroides (ATA)<\/a> recomanen la seva aplicaci\u00f3.<\/p>\n

\n

\"Oscar-Vidal\"<\/strong><\/em><\/h4>\n

“El Sistema Bethesda \u00e9s objectiu i fa que, independentment de l’hospital, ciutat o pa\u00eds d’origen de la mostra, la interpretaci\u00f3 dels resultats sigui senzilla”<\/strong><\/span><\/h4>\n

Dr. Oscar Vidal<\/a><\/p><\/blockquote>\n

Amb la\u00a0informaci\u00f3 ecogr\u00e0fica<\/strong><\/a>\u00a0i\u00a0patol\u00f2gica (Sistema Bethesda),<\/strong>\u00a0estem en disposici\u00f3 de proposar al pacient la millor conducta a seguir.<\/p>\n

\n

\"BANNER-CITA-VIDAL\"<\/a><\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"

Com hem explicat anteriorment,\u00a0l’Ecografia cervical\u00a0permet estratificar el\u00a0risc de malignitat del n\u00f2dul tiro\u00efdal\u00a0en funci\u00f3 de les caracter\u00edstiques ecogr\u00e0fiques, per\u00f2 aix\u00f2 no \u00e9s suficient per poder prendre una decisi\u00f3 respecte a indicar una intervenci\u00f3 quir\u00fargica.\u00a0Un cop tenim una alta sospita de malignitat, el seg\u00fcent\u00a0pas terap\u00e8utic ha de ser la realitzaci\u00f3 d’una\u00a0bi\u00f2psia de teixit\u00a0per a la seva an\u00e0lisi […]<\/p>\n","protected":false},"author":2,"featured_media":340,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[87,88],"tags":[104,134,144,7],"yoast_head":"\nDiagn\u00f2stic del n\u00f2dul tiro\u00efdal, la bi\u00f2psia i el Sistema Bethesda<\/title>\n<meta name=\"description\" content=\"Quan tenim sospita de malignitat del n\u00f2dul tiro\u00efdal, el seg\u00fcent pas es la 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