细针穿刺、CT、MRI及超声造影在甲状腺结节良恶性鉴别诊断中的应用价值

发布时间：2018-03-13 12:11

  本文选题：甲状腺结节　切入点：细针穿刺　出处：《广西医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:评价细针穿刺细胞学检查(FNA)、CT、MRI及超声造影(CEUS)在甲状腺癌诊断中的应用价值,指导临床更好、更合理地运用这些检查进行结节良恶性的鉴别。方法:回顾性分析广西医科大学第一附属医院2015年8月-2016年11月份经手术病理证实的226例甲状腺结节患者共282个结节(其中,良性结节193个,恶性结节89个),术前行FNA、CT、MRI、CEUS中的一项或多项检查的影像学及组织病理学资料,各组间年龄比较进行方差分析,各组间性别的比较采用行×列表卡方检验,分别计算FNA、CT、MRI、CEUS以及两两联合诊断甲状腺癌的准确率等各项诊断效能,并进一步计算根据结节直径分组(A组:直径≤1cm,B组:直径1cm)后的FNA、CEUS及CT的上述指标,再比较各项检查及两两联合后的准确率是否有差异。准确率的比较采用Fisher精确检验。结果:各检查组间年龄、性别比较无统计学差异。FNA在诊断甲状腺癌中的准确率为87.93%;CT为67.50%;CEUS为78.26%;MRI为60.00%。两两准确率的比较:FNA与CT比较,FNA与MRI以及CEUS与CT比较,差异有统计学意义(P0.05);FNA与CEUS比较,CEUS与MRI比较,以及CT与MRI比较差异无显著性(P0.05)。所有两两联合检查的准确率比较差异无显著性(P0.05)。A组(≤1cm组)中,FNA的准确率为92.86%;CT为61.22%;CEUS为65.85%。A组组内两两准确率比较:FNA与CT比较,FNA与CEUS比较,差异具有显著性(P0.05);CEUS与CT比较,差异无显著性(P0.05)。B组(1cm组)中,FNA准确率为86.36%;CT为70.75%;CEUS为88.68%。B组组内两两准确率比较:FNA与CT比较,CEUS与CT比较,差异有统计学意义(P0.05);FNA与CEUS比较,差异无显著性(P0.05)。结论:在甲状腺良恶性鉴别诊断上,不论结节大小FNA的诊断效能均优于CT和MRI;结节≤1cm时,FNA的诊断效能优于CEUS;结节1cm时,CEUS的诊断效能优于CT。而CT与MRI的准确率差异并无显著性。
[Abstract]:Objective: to evaluate the value of fine needle aspiration cytology in the diagnosis of thyroid carcinoma. Methods: a retrospective analysis was made of 282 thyroid nodule cases in the first affiliated Hospital of Guangxi Medical University from August 2015 to November 2016, which were proved by operation and pathology. There were 193 benign nodules and 89 malignant nodules. The imaging and histopathological data of one or more items of FNAOCTMRICEUS were performed before operation. The age of each group was analyzed by ANOVA, and the sex of each group was compared by X list chi-square test. The diagnostic efficacy of MRICEUS and the accuracy rate of the combined diagnosis of thyroid carcinoma were calculated, and the above indexes of FNACEUS and CT were further calculated in group A (diameter 鈮，

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