CT、MRI、CEUS及细针穿刺诊断甲状腺良恶性病变的价值观察  

Value of CT,MRI,CEUS and Fine Needle Aspiration in the Diagnosis of Benign and Malignant Thyroid Lesions

作　　者：彭刿 庞蓉[2] 马良[1,2] 程欣然 PENG Gui;PANG Rong;Ma Liang;CHENG Xin-ran(General Hospital of Pangang Group,Functional division,General surgery,Panzhihua 617000,Sichuan Province,China;The Third People's Hospital of Panzhihua,Acute branch,Panzhihua 617000,Sichuan Province,China;Department of Breast and nail Surgery,Ezhou Central Hospital,Ezhou 436000,Hubei Province,China)

机构地区：[1]攀钢集团总医院功能科,普外科,四川攀枝花617000 [2]攀枝花市第三人民医院急性科,四川攀枝花617000 [3]鄂州市中心医院乳甲外科,湖北鄂州436000

出　　处：《中国CT和MRI杂志》2022年第12期41-43,共3页Chinese Journal of CT and MRI

摘　　要：目的探究电子计算机断层扫描(CT)、磁共振成像(MRI)、超声造影(CEUS)及细针穿刺细胞学(FNAC)诊断甲状腺结节(TN)良恶性病变的价值。方法回顾性分析2018年1月至2019年12月收治94例(105个结节)甲状腺病变患者的临床资料,所有患者均行CT、MRI、CEUS及FNAC检查。分析总结影像学特征,并以术后病理检查结果作为金标准,评估各检查方法的诊断价值。结果术后病理检查确诊恶性结节38个,良性67个。CT、MRI、CEUS检查TN良恶性病变均有各自的影像学特征。以术后病理检查结果为金标准,FNAC特异度92.54%、准确率90.48%、阳性预测值86.84%、阴性预测值92.54%,均显著高于CT检查的52.63%、74.63%、55.67%、54.05%、和73.53%及MRI检查的68.42%、70.15%、69.52%、56.52%和79.66%差异有统计学意义(P<0.05);高于CEUS检查的86.56%、83.81%、76.92%、87.88%,但两者对比差异无统计学意义(P>0.05)。CEUS联合FNAC检查的灵敏度92.11%、特异度94.03%、准确率93.33%、阳性预测值89.74%、阴性预测值95.45%,均有所提升,但与FNAC诊断结果对比差异无统计学意义(P>0.05)。结论CT、MRI、CEUS及细针穿刺均在甲状腺良恶性病变有一定的诊断价值,综合考虑细针穿刺为最优诊断方法;CEUS联合FNAC诊断未增加诊断效能。Objective To explore the value of computerized tomography(CT),magnetic resonance imaging(MRI),contrast-enhanced ultrasound(CEUS)and fine needle aspiration cytology(FNAC)in the diagnosis of benign and malignant thyroid nodules(TN).Methods The clinical data of 94 patients(105 nodules)with thyroid lesions admitted from January 2018 to December 2019 were retrospectively analyzed.All patients underwent CT,MRI,CEUS and FNAC.The imaging characteristics were analyzed and summarized,and the postoperative pathological examination results were used as the gold standard to evaluate the diagnostic value of each examination method.Results Postoperative pathological examination confirmed 38 malignant nodules and 67 benign nodules.CT,MRI,and CEUS had their own imaging characteristics on TN benign and malignant lesions.Taking postoperative pathological examination results as the gold standard,the sensitivity,specificity,accuracy rate,positive predictive value and negative predictive value of FNAC were 86.84%,92.54%,90.48%,86.84%,and 92.54%,which were significantly higher than those of CT with 52.63%,74.63%,55.67%,54.05%and 73.53%,and those of MRI with 68.42%,70.15%,69.52%,56.52%and 79.66%,(P<0.05),which were higher than those of those of CEUS with 78.94%,86.56%,83.81%,76.92%,and 87.88%,but here were no statistically significant differences(P>0.05).The sensitivity,specificity,accuracy rate,positive predictive value and negative predictive value of CEUS combined with FNAC were 92.11%,94.03%,93.33%,89.74%,and 95.45%,and all were improved,but there were no statistically significant differences compared with the diagnostic results of FNAC(P>0.05).Conclusion CT,MRI,CEUS and fine needle aspiration have certain diagnostic value on benign and malignant thyroid lesions,and fine needle aspiration is the best diagnostic method by comprehensive consideration.CEUS combined with FNAC does not increase the diagnostic efficacy.

关 键 词：甲状腺 良恶性病变 CT MRI 超声造影 细针穿刺 诊断 

分 类 号：R445.3[医药卫生—影像医学与核医学]