超声引导下甲状腺结节粗针穿刺活检临床应用价值  

A clinical study of ultrasonography-guided core-needle biopsy of thyroid nodules

作　　者：蔡晓频[1,2] 徐建红[3] 靳霞[4] 王知力[3] 安力春[3] 唐杰[3] 

机构地区：[1]北京协和医学院研究生院,北京100730 [2]中日友好医院内分泌科 [3]解放军总医院超声科 [4]北京航天中心医院放射科

出　　处：《中华医学超声杂志（电子版）》2012年第7期61-63,共3页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨超声引导下甲状腺结节粗针穿刺活检(CNB)临床应用价值。方法回顾性分析行超声引导下甲状腺结节CNB的194例患者共204个结节的超声检查资料和病理检查资料。结果 204个甲状腺结节中,193个结节穿刺成功,穿刺成功率为94.6%(193/204),无一例发生穿刺并发症。恶性结节占57.5%(111/193),其中乳头状癌占96.4%(107/111)。良性结节占42.5%(82/193)。恶性结节中微小结节所占比例为61.3%(68/111),高于良性结节的40.2%(33/82),且差异有统计学意义(χ2=5.7,P<0.05)。恶性结节中多结节所占比例为71.2%(79/111),低于良性结节的87.8%(72/82),但差异无统计学意义。恶性结节中微钙化所占比例为31.5%(35/111),低回声实性结节所占比例为80.2%(89/111),钙化结节所占比例为63.1%(70/111),均高于良性结节的20.7%(17/82)、63.4%(52/82)和58.5%(48/82),但差异均无统计学意义。结论甲状腺低回声实性微小结节恶性度较高,与是否为单结节或多结节以及是否存在钙化无关。甲状腺结节超声引导下CNB是一种安全、准确的鉴别甲状腺结节良恶性的方法。Objective To evaluate the diagnostic value of ultrasonography-guided core-needle biopsy（ US-guided CNB） of thyroid nodules. Methods US-guided CNB was performed in a total of 204 nodules from 194 patients and all histologic results and ultrasound findings were reviewed. Results Of 204 US-guided CNB samples,54. 4% （ 111 /204） were histologically diagnosed malignant and 40. 2% （ 82 /204） were benign. In malignant group,papillary carcinoma accounted for 96. 4% （ 107 /111） . The successful rate of biopsy was 94. 6% （ 193 /204 ） and no biopsy complications took place. Compared with the proportion of micronodules（ 40. 2% ） in benign group,the percentage of that in malignant group （ 61. 3% ） increased evidently（ χ 2 = 5. 7,P 0. 05） . The proportion of multiple nodules in malignant group（ 71. 2% ,79 /111） was less than that （ 87. 8% ,72 /82 ） in benign group,but the difference was not statistically significant. The proportions of microcalcification and hypoechoic solid nodules were 31. 5% （ 35 /111） and 80. 2% （ 89 /111） , respectively in malignant group,which were higher than those（ 20. 7% and 63. 4% ,respectively） in benign group,but the difference had no statistical significance. The proportion of calcified nodule in benign group was similar to that in malignant group（ 58. 5% vs 63. 1% ） with no significant difference. Conclusions Regardless of nodule number and calcification,hypoechoic solid micronodules have highly malignant possibilities. US-guided CNB is a safe and accurate diagnostic test for detecting malignant thyroid nodules.

关 键 词：超声检查 甲状腺结节 粗针穿刺活检 

分 类 号：R445.1[医药卫生—影像医学与核医学]