摘要
目的对比超声引导下细针抽吸活检术(US-FNA)、超声造影在甲状腺微小结节诊断中的应用价值。方法选取甲状腺影像报告和数据系统(TI-RADS)3~4级甲状腺微小结节患者152例(共152个结节),其中良性结节90个,恶性结节62个。术前所有患者均接受US-FNA和超声造影检查,以术后病理结果为金标准,评价两种方法对甲状腺微小结节的诊断效能。分析US-FNA检查穿刺针感与超声造影增强模式的关系。结果US-FNA诊断恶性甲状腺微小结节的灵敏度、特异度、准确度、阳性预测值、阴性预测值分别为79.03%、91.11%、86.18%、85.96%、86.32%,超声造影分别为51.61%、82.22%、69.74%、66.67%、71.15%,超声造影的灵敏度、准确度、阳性预测值及阴性预测值均高于US-FNA(均P<0.05)。良性、恶性甲状腺微小结节超声造影增强模式与US-FNA针感均有关(P<0.05),即结节呈低增强模式时有针感的可能性更大。结论与US-FNA相比,超声造影鉴别诊断良恶性甲状腺微小结节存在一定局限性;临床上在常规二维超声基础上结合超声造影,并辅以US-FNA针感进行判断,有助于TI-RADS 3~4级甲状腺微小结节性质的诊断。
Objective To compare the application value of ultrasound-guided fine needle aspiration biopsy(US-FNA)versus contrast-enhanced ultrasound(CEUS)in the diagnosis of thyroid micronodules.Methods A total of 152 patients with thyroid micronodules of thyroid imaging reporting and data system(TI-RADS)grade 3-4(152 nodules)were selected,including 90 benign nodules and 62 malignant nodules.All the patients underwent US-FNA and CEUS examinations preoperatively,and the diagnostic efficacies of the two methods for thyroid micronodules were assessed with the postoperative pathological results as the gold standard.The relationship between needle sensation of US-FNA and enhancement mode of CEUS was analyzed.Results For diagnosing malignant thyroid micronodules,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value were 79.03%,91.11%,86.18%,85.96%and 86.32%by using US-FNA,and were 51.61%,82.22%,69.74%,66.67%and 71.15%by using CEUS,respectively.CEUS possessed higher sensitivity,accuracy,positive and negative predictive values as compared with US-FNA(all P<0.05).In benign and malignant thyroid micronodules,the enhancement mode of CEUS correlated with needle sensation of US-FNA(P<0.05),indicating that it was more likely to have needle sensation in nodules in decreased enhancement mode.Conclusion By comparison with US-FNA,CEUS has certain limitations in the differential diagnosis between benign and malignant thyroid micronodules.Clinically,CEUS combined with adjuvant needle sensation of US-FNA on the basis of conventional two-dimensional ultrasound is conductive to quality diagnosis of thyroid micronodules of TI-RADS grade 3-4.
作者
塔娜
王霞
TA Na;WANG Xia(Department of Ultrasound,the Second Affiliated Hospital of Xinjiang Medical University,Urumqi 830063,China)
出处
《广西医学》
CAS
2020年第23期3015-3018,共4页
Guangxi Medical Journal
基金
新疆维吾尔自治区自然科学基金(2019D01C241)。
关键词
甲状腺微小结节
超声引导下细针穿刺
超声造影
甲状腺影像报告及数据系统3~4级
鉴别诊断
针感
增强模式
Thyroid micronodule
Ultrasound-guided fine needle puncture
Contrast-enhanced ultrasound
Thyroid imaging reporting and data system grade 3-4
Differential diagnosis
Needle sensation
Enhancement mode
