超声引导下甲状腺细针穿刺细胞学检查与超声造影联合检查对甲状腺结节定性诊断的价值  

Value of ultrasound-guided fine needle aspiration cytology combined with contrast-enhanced ultrasound in the qualitative diagnosis of thyroid nodules

作　　者：乔旭东 QIAO Xudong(Department of Ultrasound Medicine,Ninth Hospital of Xi’an,Shaanxi Province,Xi’an710054,China)

机构地区：[1]陕西省西安市第九医院超声医学科,陕西西安710054

出　　处：《中国医药导报》2022年第34期149-153,共5页China Medical Herald

摘　　要：目的探讨超声引导下甲状腺细针穿刺细胞学检查(US-FNAB)、超声造影(CEUS)联合检查对甲状腺影像报告和数据系统(TI-RADS)4类甲状腺结节定性诊断的价值。方法回顾性分析2019年1月至2021年12月陕西省西安市第九医院收治的298例TI-RADS 4类甲状腺结节患者的临床资料,共326个甲状腺结节,经术后病理学检查证实,恶性结节182个、良性结节144个。所有患者均进行CEUS检查、US-FNAB检查及US-FNAB、CEUS联合检查。以术后病理学检查为金标准,比较两组US-FNAB、CEUS及其联合检查的良恶性检出情况,US-FNAB、CEUS及其联合检查的诊断价值,记录良恶性结节CEUS灌注、US-FNAB针感特点。结果CEUS检查出恶性TI-RADS 4类甲状腺结节180个,良性TI-RADS 4类甲状腺结节146个;US-FNAB检查出恶性甲状腺结节181个,良性甲状腺结节145个;联合检查出恶性甲状腺结节208个,良性甲状腺结节118例。CEUS、US-FNA及联合检查结果与术后病理检查结果具有较高的一致性。恶性CEUS灌注情况多表现为低增强,良性多表现为高增强或等增强;恶性中US-FNAB有针感的占比为81.77%,高于良性的19.31%(P<0.05)。结论CEUS、US-FNA及联合检查可对TI-RADS 4类甲状腺结节良恶性进行有效判定,其中CEUS增强特点及US-FNAB针感可提供依据,而US-FNAB、CEUS联合检查在良恶性的鉴别中具有较高的敏感度,诊断价值较高。Objective To investigate the value of ultrasound-guided thyroid fine needle aspiration cytology(US-FNAB)and contrast-enhanced ultrasound(CEUS)in the qualitative diagnosis of thyroid imaging reporting and data system(TI-RADS)class 4 thyroid nodules.Methods The clinical data of 298 patients with TI-RADS class 4 thyroid nodules admitted to Ninth Hospital of Xi’an from January 2019 to December 2021 were retrospectively analyzed,a total of 326 thyroid nodules were confirmed by postoperative pathological examination,included 182 malignant nodules and 144 benign nodules.All patients underwent CEUS examination,US-FNAB examination,and combined US-FNAB and CEUS examination.Postoperative pathological examination as the gold standard,the benign and malignant detection of US-FNAB,CEUS,and their combined examination,the diagnostic value of US-FNAB,CEUS,and their combined examination were compared between the two groups,and the characteristics of CEUS perfusion and US-FNAB needle sensation of benign and malignant nodules were recorded.Results CEUS detected 180 cases of malignant TI-RADS class 4 thyroid nodules and 146 cases of benign TI-RADS class 4 thyroid nodules;US-FNAB detected 181 cases of malignant and 145 cases of benign;208 cases of malignant and 118 cases of benign by jointly detected.The results of CEUS,US-FNA,and combined examination were consistent with those of postoperative pathological examination.The perfusion of CEUS in malignant showed low enhancement,while that in benign showed high enhancement or equal enhancement.In the malignant,the proportion of needle sensation in the US-FNAB was 81.77%,which was higher than 19.31%in the benign group(P<0.05).Conclusion CEUS,US-FNA,and combined examination can effectively determine the benign and malignant of TI-RADS class 4 thyroid nodules,CEUS-enhanced features and US-FNAB acupuncture can provide the basis,and the combined examination of US-FNAB and CEUS have high sensitivity in the identification of benign and malignant,and have high diagnostic value.

关 键 词：甲状腺结节 超声造影 超声 穿刺 细胞学检查 

分 类 号：R581[医药卫生—内分泌]