超声引导下粗针穿刺活检鉴别诊断甲状腺结节良恶性  

Ultrasound-guided core-needle biopsy in differential diagnosis of benign and malignant thyroid nodules

作　　者：张云山[1] 杨克[1] 任贺[1] 刘秋颖[1] 邱璇[1] 

机构地区：[1]中国人民解放军海军总医院超声医学科,北京100048

出　　处：《中国介入影像与治疗学》2014年第6期349-352,共4页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的探讨超声引导下粗针穿刺活检（US-CNB）诊断甲状腺结节良恶性的价值。方法回顾性分析146例接受US-CNB的甲状腺疾病患者（152个结节）的病理资料，以术后病理结果为金标准，计算US-CNB病理诊断甲状腺恶性肿瘤的准确率。结果US-CNB病理诊断甲状腺恶性肿瘤的敏感度、特异度、准确率分别为97．82％（90／92）、96．43％（54／56）和97．30％（144／148）；对直径≥0．7cm结节的诊断准确率[0．7～1．0cm：95．65％（22／23），1．1～1．5cm：100％（38／38），1．6～2．0cm：100％（50／50），〉2．0cm：100％（29／29）]高于直径〈0．7cm结节[62．50％（5／8），P均〈0．05]。结论US-CNB鉴别诊断甲状腺良恶性结节操作简单、定位准确、创伤小、并发症少、准确率高，可作为非手术条件下获取病理组织的首选方法。Objective To explore the value of ultrasound-guided core-needlebiopsy （US-CNB） in differential diagnosis of benign and malignant thyroid nodules. Methods Pathological data of 146 patients （with 152 nodules thyroid nodules） who underwent US-CNB were retrospectively analyzed. The accuracy rate of US-CNB in diagnosing malignant thyroid nodules were calculated taking postoperative pathology as gold standards. Results The sensitivity, specificity, accuracy rate of US-CNB in diagnosing malignant thyroid nodule was 97.82% （90/92）, 96.43% （54/56） and 97.30% （144/148）, respectively. The accuracy rate of US-CNB in diagnosing malignant thyroid nodules with diameter ≥0. 7 cm （0.7- 1.0 cm： 95.65% [-22/23], 1.1-1.5 cm： 100% [38/38], 1.6-2.0 cm： 100% [50/50], 〉2.0 cm： 100% [29/29]） was higher than that for nodules with diameter 〈0.7 cm （62.50% [5/8], all P〈0. 05）. Conclusion US-CNB has high accuracy rate in differential diagnosis of benign and malignant thyroid nodules with simple operation, accurate positioning, small trauma and less complications, which can be used as the preferred method to obtain pathological specimen under non-surgical condition.

关 键 词：超声检查 介入性 甲状腺结节 活组织检查 针吸 

分 类 号：R445.1[医药卫生—影像医学与核医学] R736.1[医药卫生—诊断学]