能量多普勒半定量分级在甲状腺结节细针穿刺中的应用  

The application of semi-quantitative scoring of PDUS in the fine needle aspiration biopsy for thyroid nodules

作　　者：阳建军[1] 徐华军[1] 陈文显[1] 韩运生[1] 沈吉[1] 方伟 YANG Jianjun;XU Huajun;CHEN Wenxian;HAN Yunsheng;SHEN Ji;FANG Wei(Department of Ultrasound, Huzhou Municipal Central Hospital, Huzhou, Zhejiang Province 313000, China)

机构地区：[1]湖州市中心医院超声科,浙江313000 [2]湖州市中心医院病理科,浙江313000

出　　处：《介入放射学杂志》2018年第6期534-538,共5页Journal of Interventional Radiology

基　　金：浙江省湖州市科技计划项目(2016GYB34)

摘　　要：目的 探讨能量多普勒半定量分级在甲状腺结节细针穿刺中的应用价值。方法 337例(个)甲状腺结节随机分配入研究组(172例)和对照组(165例)进行细针穿刺,研究组细针穿刺时依据结节内能量多普勒半定量分级选择不同穿刺方式,对照组则以(常规)无负压穿刺抽吸,比较两组穿刺成功率及细胞学诊断结果。结果 研究组穿刺成功率95.4%高于对照组86.7%(P=0.005),在有确定意义的细胞学诊断结果中研究组117例(68.0%)高于对照组85例(51.5%)(P=0.002);两组鉴别结节良恶性的灵敏度90.5%比76.9%,特异度92.3%比78.2%,准确率91.3%比77.6%,研究组在灵敏度、特异度及准确率上均优于对照组(P<0.05)。结论 能量多普勒半定量分级能提高甲状腺结节细针穿刺成功率及细胞学诊断效能。Objective To discuss the application value of semi-quantitative scoring of power Doppler ultrasound （PDUS） in fine needle aspiration biopsy for thyroid nodules. Methods A total of 337 thyroid nodules were randomly assigned into the experimental group （n=172） and the control group （n=165）. Fine needle aspiration biopsy was carried out for all thyroid nodules. In performing fine needle biopsy for the nodules of experimental group, different puncture methods were used according to the semi- quantitative scoring of PDUS inside the thyroid nodule, while routine non- negative pressure aspiration biopsy was employed for the nodules of control group. The puncturing success rate and the cytological diagnosis were compared between the two groups. Results The puncturing success rate in the experimental group was 95.4%, which was significantly higher than 86.7% in the control group （P=0.005）. Definite cytological diagnosis was obtained for 117 lesions （68.0%） in the experimental group, which was remarkably higher than that in the control group （85 lesions, 51.5% ）, the difference was statistically significant （P=0.002）. In differentiating benign from malignant nodules, the sensitivity of the experimental group and the control group was 90.5% and 76.9% respectively, the specificity was 92.3% and 78.2% respectively, and the accuracy rate was 91.3% and 77.6% respectively. The experimental group was superior to the control group in the sensitivity, specificity and accuracy rate of differentiation between benign and malignant nodules （P〈0.05）. Conclusion The use of semi- quantitative scoring of PDUS can effectively improve the puncturing success rate and the cytological diagnostic accuracy of fine needle aspiration biopsy for thyroid nodules.

关 键 词：甲状腺结节 细针穿刺 能量多普勒 细胞学检查 

分 类 号：R581[医药卫生—内分泌]