甲状腺结节超声引导下细针抽吸细胞学无法诊断结果的影响因素分析  

Analysis of influences for ultrasound guided- fine needle aspiration cytology failing to diagnosis thyroid nodules

作　　者：邬宏恂[1] 张冰洁[1] 臧亚萍[1] 王隽[1] 朱蓓琳[1] 曹跃龙[1] 

机构地区：[1]江苏省原子医学研究所(卫生部核医学重点实验室/江苏省分子核医学重点实验室)附属江原医院超声科,江苏省无锡市214063

出　　处：《临床超声医学杂志》2014年第8期523-526,共4页Journal of Clinical Ultrasound in Medicine

基　　金：江苏省卫生厅科研项目(H201227)

摘　　要：目的探讨导致超声引导下细针抽吸术(FNA)检查甲状腺结节出现细胞学无法诊断结果的影响因素。方法 432例甲状腺结节患者,共457个结节,行超声引导下FNA检查,按照细胞学结果分为无法诊断和适合诊断,比较两者结节的大小、位置、结构、钙化、穿刺点的回声和血流情况,以及穿刺针芯内径和抽吸技术。对上述参数进行单变量分析,运用多参数Logistic回归分析有意义的单变量参数独立预测价值。结果两者结节的上下径<5mm、环状钙化、穿刺点低回声、穿刺点无血流或丰富血流、背侧位置及负压抽吸法的差异有统计学意义(P<0.05),Logistic回归分析发现前四者为独立影响因素。结论 FNA应避免选择低回声并且血流不丰富区域进行抽吸,采取毛细法有助于降低FNA的无法诊断率。Objective The purpose of this study was to discuss the influence for ultrasound guided-fine needle aspiration（UG-FNAC）cytology failing to diagnose thyroid nodules. Methods A total of 457 thyroid nodules in 432 patients were performed UG-FNA and divided into two groups according to cytology results including group with diagnostic availability and group without diagnostic availability. The nodule size,location,structure,calcification,ultrasonic echo in puncture point and blood flow in the two groups were compared. The stylet inner diameter of puncture needles and aspiration technique were also compared. The above parameters were performed univariate analysis and the independent predictive value of significant single variables was analyzed by Logistic regression. Results The nodule size,rim calcification,hypo-echogenicity and hypo-vascularity in the two groups were influcence factors and significantly different. Conclusion The localization of needle tip in UG-FNAC should not be selected in the areas with hypo-echogenicity or hypo-vascularity and capillary action technique will help decrease the failure rate of FNAC in the diagnose of thyroid nodules.

关 键 词：超声检查 细针抽吸 甲状腺 结节 

分 类 号：R653[医药卫生—外科学] R445.1[医药卫生—临床医学]