超声弹性成像联合超声引导下针吸技术在甲状腺C-TIRADS 4a类结节诊断中的应用  

Application of Ultrasound-Guided Needle Aspiration Cytology Combined with Ultrasound Elastography in the Differential Diagnosis of C-TIRADS Type 4a Thyroid Nodules

作　　者：张娜[1] 闫凤芝 李娅 杨姣 杜宪 王天民[1] 赵娜[1] Zhang Na;Yan Fengzhi;Li Ya;Yang Jiao;Du Xian;Wang Tianmin;Zhao Na(Department of Ultrasound,The Second Central Hospital of Baoding,Zhuozhou,Hebei 072750,China)

机构地区：[1]保定市第二中心医院超声科,河北省涿州市072750

出　　处：《中国超声医学杂志》2023年第9期1066-1069,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的分析超声弹性成像(UE)联合超声引导下针吸细胞学(US-GNAC)检查在甲状腺中国版的甲状腺影像学报告和数据系统(C-TIRADS)4a类结节疾病鉴别诊断中的应用价值。方法回顾性收集经手术病理证实的甲状腺结节患者98例,共131个结节,患者术前均接受UE、US-GNAC检查,以手术病理结果为金标准,分别计算UE、US-GNAC单独及联合诊断结节良恶性的灵敏度、特异度、准确度、阳性预测值及阴性预测值,并比较诊断效能。结果131个结节中恶性结节占69.47%(91/131),良性结节占30.53%(40/131)。UE诊断恶性结节75个、良性结节56个;US-GNAC诊断细胞学阳性结节89个、细胞学阴性结节42个;UE联合US-GNAC诊断恶性结节98个、良性结节33个。UE联合US-GNAC诊断甲状腺C-TIRADS 4a类结节的灵敏度高于UE、US-GNAC单独诊断(χ^(2)=4.741,P=0.029;χ^(2)=9.867,P=0.002),UE联合US-GNAC诊断甲状腺C-TIRADS 4a类结节的阴性预测值高于UE单独诊断(χ^(2)=6.587,P=0.010)。结论UE联合US-GNAC诊断甲状腺C-TIRADS 4a类结节较两者单独应用可明显提高诊断的灵敏度,具有一定的临床应用价值。Objective To analyze and observe the application value of ultrasound-guided needle aspiration cytology(US-GNAC)combined with ultrasound elastography(UE)in the differential diagnosis of Chinese thyroid imaging reporting and data system(C-TIRADS)type 4a thyroid nodules.Methods 98 patients with thyroid nodules confirmed by surgery and pathology were collected between,with a total of 131 nodules.All patients were examined by US-GNAC and UE.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value were calculated by taking pathological results as the gold standard,and the diagnostic efficiency was compared.Results Among 131 nodules in 98 patients confirmed by surgery and pathology,malignant nodules accounted for 69.47%(91/131)and benign nodules accounted for 30.53%(40/131).US-GNAC diagnosed 89 cytology-positive nodules and 42 cytology-negative nodules,and UE diagnosed 75 malignant nodules and 56 benign nodules.98 malignant nodules and 33 benign nodules were diagnosed by US-GNAC combined with UE.The sensitivity of US-GNAC combined with UE in diagnosing C-TIRADS type 4a thyroid nodules was higher than that of US-GNAC or UE alone(χ^(2)=4.741,P=0.029;χ^(2)=9.867,P=0.002),and the negative predictive value of US-GNAC combined with UE was higher than that of UE alone(χ^(2)=6.587,P=0.010).Conclusions US-GNAC combined with UE in the diagnosis of C-TIRADS type 4a thyroid nodules can significantly improve the diagnostic sensitivity compared with the two alone,and it has certain clinical application value.

关 键 词：超声弹性成像 超声引导下针吸细胞学 甲状腺乳头状癌 中国版的甲状腺影像学报告和数据系统 

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]