Very high prevalence of thyroid nodules detected by high frequency (13 MHz) ultrasound examination

Eur J Clin Invest. 2009 Aug;39(8):699-706. doi: 10.1111/j.1365-2362.2009.02162.x.


Background: The prevalence of thyroid nodules in a healthy population is high: in the German Papillon study, nationwide ultrasound screening of more than 90 000 people using 7.5 MHz scanners revealed the presence of thyroid nodules in 33% of the normal population. A study employing more sensitive 13 MHz scanners has not been conducted so far.

Materials and methods: Six hundred and thirty-five consecutive patients (33% female, 67% male, mean 56.7 years) presenting for a preventive health check up underwent ultrasound screening of the thyroid gland (Siemens Acuson Antares, 13 MHz-linear scanner, B-mode and Power mode) and measurement of the basal TSH (thyroid stimulating hormone) value. Size and degree of vascularization of the thyroid gland and of nodules were determined and analysed retrospectively.

Results: In 432 of 635 patients, thyroid nodules could be detected with an increasing incidence with age, in 338 without goiter. Mean thyroid size was 12.3 mL for women and 20.5 mL for men correlating strongly with body weight. Fifty-three percentage of the nodules were smaller than 5 mm. Incidence of thyroid dysfunction was only 4%. No cancerous lesions could be found.

Conclusions: Using the 13 MHz technology, we found a substantially higher prevalence of thyroid nodules (68%) than the Papillon study (33%). Even if our population is older than in Papillon, the difference remains in comparable age groups. This is due to the higher sensitivity of 13 MHz scanning. Our study underlines the clinical significance of iodine deficiency and should renew the discussion on routine iodine supplementation.

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Female
  • Germany / epidemiology
  • Humans
  • Iodine / deficiency*
  • Male
  • Middle Aged
  • Prevalence
  • Retrospective Studies
  • Risk Factors
  • Thyroid Gland / diagnostic imaging*
  • Thyroid Nodule / diagnostic imaging*
  • Thyroid Nodule / epidemiology
  • Thyrotropin / deficiency*
  • Ultrasonography


  • Thyrotropin
  • Iodine