超声检查及引导穿刺活检在甲状腺微小结节良恶性中的鉴别诊断价值  

The value of ultrasonography and ultrasound-guided needle biopsy in the differential diagnosis of benign and malignant thyroid nodules

作　　者：留碧丽[1] 夏文霞[1] 李敏[1] 欧斐[1] 姚洁[1] 姚春[1] LIU Bili;XIA Wenxia;LI Min;OU Fei;YAO Jie;YAO Chun(Department of Ultrasonography, Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou 310007, P.R.China)

机构地区：[1]浙江省杭州市中医院超声科,浙江杭州310007

出　　处：《医学影像学杂志》2021年第11期1864-1867,共4页Journal of Medical Imaging

基　　金：浙江省医药卫生科技计划项目(编号:2020KY756)。

摘　　要：目的探讨超声检查与引导下甲状腺细针穿刺活检(FNAB)和液基薄层细胞学(TCT)检查在甲状腺微小结节良恶性中的鉴别诊断价值。方法选取经病理证实的187个甲状腺微小结节,采用Logistic回归分析超声检查资料,分析病灶内部回声、形态、边缘、钙化、血流因素在甲状腺微小结节良恶性间的差异。采用受试者工作特征曲线(ROC)分析超声影像学特征与FNAB和TCT的诊断准确性。结果结节边缘、内部回声、形态、钙化类型、血流分级差异均有统计学意义(均P<0.05),结节声晕差异无统计学意义(P>0.05)。Logistic回归分析显示结节边缘的鉴别诊断能力最高(OR=37.160),其次为结节内部回声(OR=2.875)、结节形态(OR=2.225)ROC曲线分析的结果显示对甲状腺微小结节良恶性诊断效能高低依次为FNAB、TCT、超声检查。结论超声引导下的FNAB结合TCT检查在甲状腺微小结节的术前诊断中有很高的临床应用价值。Objective To explore the value of ultrasound imaging and ultrasound-guided fine needle aspiration biopsy(FNAB)and liquid-based thin-layer cytology(TCT)in the differential diagnosis of benign and malignant thyroid minute nodules.Methods A retrospective analysis of 187 cases of microthyroid nodules confirmed by pathology was performed.Logistic regression analysis of ultrasonographic data was used to analyze the differences between benign and malignant thyroid nodules with echogenic,morphological,marginal,calcified,and blood flow factors within the lesion.The receiver operating characteristic curve(ROC)was used to analyze the ultrasound imaging characteristics and the diagnostic accuracy of FNAB and TCT.Results There were significant differences in nodule margins,internal echo,morphology,calcification type,and blood flow grade(all P<0.05),and nodular halos were not significantly different(P>0.05).Logistic regression analysis showed that the nodule edge had the highest differential diagnosis ability(OR=37.160),followed by internal nodule echo(OR=2.875)and nodule morphology(OR=2.225).The results of ROC curve analysis showed that it was good for small thyroid nodules.The order of malignant diagnosis was FNAB,TCT,and ultrasound.Conclusion Ultrasound-guided FNAB combined with TCT has great clinical application value in the preoperative diagnosis of microthyroid nodules.

关 键 词：甲状腺微小癌 超声检查 细针穿刺活检 液基薄层细胞学 介入性 放射学 

分 类 号：R736.1[医药卫生—肿瘤] R815[医药卫生—临床医学]