甲状腺结节超声引导下穿刺活检的临床价值  

Clinic value of ultrasound-guided needle biopsy for the diagnosis of thyroid nodule lesions

作　　者：魏小丽[1,2] 于晓玲[2] 郝晓云[1] 刘方义[2] 梁萍[2] 程志刚[2] 韩治宇[2] 于杰[2] 宋志刚[2] 

机构地区：[1]山西医科大学第一临床医学院,太原030001 [2]解放军总医院,北京100853

出　　处：《军医进修学院学报》2012年第5期473-475,共3页Academic Journal of Pla Postgraduate Medical School

摘　　要：目的探讨超声引导下粗针(18G)穿刺活检(ultrasound-guided coarse needle biopsy,US-CNB)对甲状腺结节的临床诊断价值。方法对2010年10月-2011年5月在解放军总医院就诊的150例157个甲状腺结节进行US-CNB,以手术切除病理结果作为金标准,将US-CNB的病理结果与手术病理结果进行对照。US-CNB的病理学诊断分为良性、恶性、诊断不明确三类。结果 157个结节,最终诊断为恶性结节139个,良性结节18个。穿刺活检病理学诊断为恶性131个(83.45%),良性17个(10.83%),9个(5.73%)诊断不明确;US-CNB病理学诊断的灵敏度96.27%,特异度85.71%,准确度95.27%。1例(0.63%)发生穿刺后出血。取材标本的最大径≥0.4cm时可以提高诊断准确率。结论超声引导下经皮甲状腺穿刺简便、安全,是非手术条件下穿刺病检的首要方法。Objective To study the clinical diagnostic value of ultrasound-guided coarse needle（18G） biopsy（US-CNB） for diagnosis of thyroid nodule lesions. Methods One hundred and fifty patients（157 thyroid nodules） who underwent US-CNB and surgery in Chinese PLA General Hospital from October 2010 to May 2011 were included in this study. The findings in US-CNB and surgery were compared. The US-CNB demonstrated that thyroid nodule lesions could be classified as benign, malignant or uncertain. Results Of the 157 thyroid nodule lesions, 139 and 18 were diagnosed as malignant and benign respectively, while 131（81.45%）, 17（10.83%） and 9（5.73%） were diagnosed as malignant, benign and uncertain respectively by US-CNB, with a sensitivity of 96.27%, a specificity of 85.71% and an accuracy of 95.27%. Bleeding occurred in 1 patient（0.63%） after puncture. The diagnosis rate was increased when the thyroid nodule sample with its maximum diameter ≥ 0.4cm was used. Conclusion US-CNB is a safe and simple procedure for the puncture of thyroid nodule lesions when surgical sampling is impossible.

关 键 词：超声引导 甲状腺结节 穿刺活检 

分 类 号：R445.1[医药卫生—影像医学与核医学]