摘要
目的评价重复超声引导下细针穿刺活检术(US-FNAB)对于初次US-FNAB结果为BethesdaⅠ/Ⅲ类甲状腺结节的诊断价值。方法81例患者经初次US-FNAB检出84个结节BethesdaⅠ/Ⅲ类,对其行重复US-FNAB,比较标本满意率、诊断明确率及诊断类别差异,并据以分为明确组(n=49)和不明确组(n=35);根据手术及超声随访结果,排除1个无法明确判断结节后,将83个诊断明确结节又分为良性组(n=50)和恶性组(n=33);比较各组结节大小、变化及超声征象等差异。结果重复US-FNAB对80个结节(80/84,95.24%)取材满意,49个(49/84,58.33%)得出明确诊断;其对初次结果为BethesdaⅠ类与Ⅲ类结节的标本满意率、诊断明确率及诊断类别差异无统计学意义(P均>0.05)。明确组与不明确组间仅甲状腺影像报告和数据系统(TI-RADS)分类差异具有统计学意义(P<0.05);良性组与恶性组结节回声、大小变化、纵横比、边界及TI-RADS分类差异均具有统计学意义(P均<0.05)。结论重复US-FNAB对明确诊断和临床管理BethesdaⅠ/Ⅲ类甲状腺结节具有重要价值;对纵横比>1、边界不清、回声低、大小变化及TI-RADS类别较高的结节应行重复US-FNAB。
Objective To observe the value of repeated ultrasound-guided fine-needle aspiration biopsy(US-FNAB)for diagnosis of initial US-FNAB results as BethesdaⅠ/Ⅲtype thyroid nodules.Methods Eighty-one patients with 84 initial US-FNAB diagnosed BethesdaⅠ/Ⅲtype thyroid nodules underwent repeated US-FNAB.The specimen satisfaction rate,diagnostic accuracy rate and diagnostic category of repeated US-FNAB were compared betweenⅠ/Ⅲtype nodules.Then the nodules were divided into definite group(n=49)and ambiguous group(n=35)according to repeated US-FNAB,as well as benign group(n=50)and malignant group(n=33)according to the outcomes of surgical resection or ultrasound following-up after excluding of 1 nodule since ambiguous estimation.The sizes,changes and ultrasonic manifestations of the nodules were compared between different groups.Results Satisfactory samples were obtained in repeated US-FNAB of 80(80/84,95.24%),while definite diagnosis was obtained in 49(49/84,58.33%)nodules.There was no statistical significance of specimen satisfaction rate,diagnostic accuracy rate nor diagnostic category of repeated US-FNAB between initial US-FNAB diagnosed BethesdaⅠandⅢtype nodules(all P>0.05).After repeated US-FNAB,significant difference was found only of the thyroid imaging reporting and data system(TI-RADS)type between definite group and ambiguous group(P<0.05).There were significant differences of the echo,size,aspect ratio,boundary and TI-RADS type between benign group and malignant group(all P<0.05).Conclusion Repeated US-FNAB was of great value for definite diagnosis and clinical management of BethesdaⅠ/Ⅲtype thyroid nodules,which was recommended for nodules with the aspect ratio>1,ill-defined boundaries,low echo,size variation and high TI-RADS types.
作者
余璐璐
刘丽萍
YU Lulu;LIU Liping(Department of Ultrasound,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)
出处
《中国医学影像技术》
CSCD
北大核心
2021年第9期1312-1316,共5页
Chinese Journal of Medical Imaging Technology
