彩超引导下甲状腺结节粗针穿刺活检的应用价值  

Color doppler ultrasound guided coarse needle biopsy of thyroid nodules

作　　者：钟荣国[1] 谢锋[1] 李洲成[1] 伍石华[1] 

机构地区：[1]邵阳医学高等专科学校附属医院甲状腺乳腺外科,422000

出　　处：《中华普外科手术学杂志（电子版）》2015年第6期29-31,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：邵阳市2012年第二批市级科技计划项目(J1257)~~

摘　　要：目的探讨彩超引导下粗针穿刺活检在甲状腺结节诊断中的应用价值。方法选取2013年12月至2015年5月住院治疗的甲状腺结节患者120例157个结节,行彩色多普勒超声引导下甲状腺结节粗针穿刺活检,比较穿刺活检结果与术后病理结果差异。结果 120例患者157个甲状腺结节中,145个甲状腺结节穿刺成功,穿刺成功率为92.36%(145/157),术后病理学确诊恶性结节98个,47个良性结节;穿刺期间无病例发生穿刺并发症;彩超引导下粗针穿刺活检对甲状腺结节良恶性鉴别诊断的准确率为93.79%(136/145),灵敏度为93.88%(92/98)、特异性为93.62%(44/47);恶性结节最大径为(1.32±0.87)cm,良性结节最大径为(1.45±0.92)cm,两者比较差异无统计学意义(P>0.05);甲状腺良恶性结节中钙化、微钙化和低回声实性结节的比例比较,差异无统计学意义(P>0.05)。结论彩超引导下甲状腺结节粗针穿刺活检有较好的应用价值,其诊断灵敏度和特异性较高,可弥补高频彩超的不足,提高甲状腺良恶性结节的早期诊断率,是一种安全可行的术前确诊方法。Objective To investigate the value of color doppler ultrasound guided coarse needle biopsy of thyroid nodules. Methods From December 2013 to May 2015,120 patients with 157 thyroid nodules were treated in our hospital by using color doppler ultrasound guided coarse needle biopsy. The difference of results from biopsy and postoperative pathological examination was compared. Results Among the 120 patients,145 thyroid nodules were punctured successfully,with a successful puncture rate of 92. 36%（ 145/157）. Postoperative pathological examination confirmed 98 patients with malignant nodules and 47 with benign nodules. There were no complications during puncture. By using color doppler ultrasound guided coarse needle biopsy in the differential diagnosis of benign and malignant thyroid nodules,the accuracy was 93. 79%（ 136/145）,the sensitivity was 93. 88%（ 92/98）,and the specificity was 93. 62%（ 44/47）. The maximum diameter of malignant nodules was（ 1. 32 ± 0. 87） cm,the maximum diameter of benign nodules was（ 1. 45 ±0. 92） cm（ P〉0. 05）. There was no significant difference in calcification of benign and malignant thyroid nodules,microcalcifications,and proportion of hypoechoic solid nodules（ P〉0. 05）. Conclusion Color Doppler ultrasound guided coarse needle biopsy of thyroid nodules is a safe and feasible method for preoperative diagnosis. The sensitivity and specificity of this method are relatively high,which could make up for the shortcomings of high frequency color ultrasound,while improving the early diagnosis rate of benign and malignant thyroid nodules.

关 键 词：甲状腺结节 超声检查 多普勒 彩色 活组织检查 针吸 

分 类 号：R445.1[医药卫生—影像医学与核医学] R581[医药卫生—诊断学]