甲状腺结节细针抽吸诊断无效的超声图像及病理结果分析  

Ultrasonographic and pathological analysis of ineffective diagnosis of fine needle aspiration of thyroid nodules

作　　者：邵静[1] 张佐炳[1] 郭秋香[1] SHAO Jing;ZHANG Zuobing;GUO Qiuxiang(Department of Ultrasound,First Affiliated Hospital of Xiamen University,Xiamen,Fujian,361000,China)

机构地区：[1]厦门大学附属第一医院超声科,福建厦门361000

出　　处：《当代医学》2021年第9期82-84,共3页Contemporary Medicine

摘　　要：目的分析细针抽吸诊断无效的甲状腺结节的超声图像,总结声像图特征,为临床工作中选取病例、提高诊断率提供帮助。方法选取2018年1月至2019年12月在厦门大学附属第一医院行超声引导下甲状腺细针抽吸并诊断无效的89例患者为研究对象,回顾性分析经手术病理证实的97个细针抽吸诊断无效甲状腺结节的超声图像,记录结节的大小、构成、距皮肤距离、钙化、比邻结构,并分析病理结果,总结细针抽吸诊断无效的原因。结果甲状腺结节细针抽吸诊断无效的超声征象有:结节位于背侧或比邻重要结构,如气管、食管、颈动脉,占比25.8%(25/97);位置适中,结节小,内部粗大钙化几乎覆盖结节,占比15.5%(15/97);结节大小适中,周边环状钙化,占比4.1%(4/97);结节较大、以囊性为主,占比10.3%(10/97);桥本背景下结节边界不清,占比8.2%(8/97)。97个结节的术后病理恶性38个,良性59个,恶性率39.2%。结论甲状腺结节细针抽吸术前的超声征象评估有助于操作者选取更好的临床处理方案,提高细针抽吸的诊断率。Objective To analyze the ultrasonic images of thyroid nodules non-diagnosed by fine needle aspiration(FNA)so as to provide help for selecting cases and improving the diagnosis rate in clinical work.Methods The ultrasonic images of 97 nodules non-diagnosed by FNA confirmed by operation were analyzed retrospectively.To record the size,appearance,depth to skin,calcification and adjacent structure of thyroid nodules,and to analyze the pathological results.Results The ultrasonic signs of non-diagnosis thyroid nodules were as follows:the Nodules are located on the dorsal side or adjacent to important structures,such as trachea,esophagus and carotid artery,accounting for 25.8%(25/97);the nodules were in the right position but small,and the internal macrocalcifications almost covers the nodules,accounting for 15.5%(15/97);nodules of moderate size,peripheral annular calcification,accounting for 4.1%(4/97);The nodules are large and mainly cystic,accounting for 10.3%(10/97);Under the background of lymphocytic thyroiditis,the boundary of the nodule is not clear,accounting for 8.2%(8/97).All the 97 nodules,38 were malignant and 59 were benign,with malignant rate of 39.2%.Conclusion The evaluation of ultrasonic signs before FNA of thyroid nodules is helpful for operators to choose better clinical treatment plan and continuously improve the diagnostic rate of FNA.

关 键 词：甲状腺结节 超声检查 超声引导细针抽吸 

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]