超声引导下细针穿刺活检和实时弹性成像联合应用诊断可疑甲状腺结节的价值

发布时间：2018-07-26 15:53

【摘要】：目的探讨超声引导下细针穿刺活检和实时弹性成像联合应用对可疑甲状腺结节的诊断价值。方法回顾性分析常规超声检查中定性困难的84例共105个可疑甲状腺结节,均同时接受实时弹性成像、超声引导下细针穿刺检查。将弹性评分结果、超声引导下细针穿刺细胞学结果与最终证实结果进行对照分析。结果在纳入研究的105个甲状腺结节中,良性病变68个(68/105,64.76%),恶性病变37个(37/105,35.24%)。常规超声联合实时弹性成像评估甲状腺结节的敏感度为72.97%(27/37),特异度为30.88%(21/68),准确率为45.71%(48/105)。细针穿刺细胞病理学诊断的敏感度为75.68%(28/37),特异度为88.24%(60/68),准确率为83.81%(88/105)。细针穿刺细胞学与常规超声联合实时弹性成像结果比较,特异度、准确率差异均有统计学意义(P均0.05)。结论超声弹性成像技术和超声引导下细针穿刺活检在评估甲状腺结节的过程中均存在局限性,联合应用可提高对于可疑结节的诊断准确率。
[Abstract]:Objective to evaluate the diagnostic value of ultrasound guided fine needle biopsy and real-time elastic imaging in suspicious thyroid nodules. Methods A total of 105 suspected thyroid nodules were analyzed retrospectively in 84 cases with difficulty in qualitative analysis. All patients underwent real-time elastic imaging and ultrasound guided fine needle puncture examination at the same time. The results of elastic score, fine needle aspiration cytology under ultrasound guidance were compared with the final confirmed results. Results among 105 thyroid nodules in the study, 68 were benign (68 / 105) and 37 were malignant (37 / 105, 35.24%). The sensitivity, specificity and accuracy were 72.97% (27 / 37), 30.88% (21 / 68) and 45.71% (48 / 105), respectively. The sensitivity, specificity and accuracy of fine needle aspiration cytopathology were 75.68% (28 / 37), 88.24% (60 / 68) and 83.81% (88 / 105), respectively. There were significant differences in specificity and accuracy between fine needle aspiration cytology and conventional ultrasound combined with real time elastic imaging (P 0.05). Conclusion Ultrasonic elastography and ultrasound-guided fine needle biopsy have limitations in the evaluation of thyroid nodules, and combined use can improve the diagnostic accuracy of suspicious nodules.
【作者单位】：上海交通大学附属第六人民医院超声医学科上海超声医学研究所;
【基金】：上海市自然科学基金(11ZR1427700)
【分类号】：R736.1;R445.1

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