常规超声、超声造影联合细针抽吸活检对甲状腺良恶性结节的鉴别诊断  

Differential diagnosis of benign and malignant thyroid nodules by conventional ultrasound, contrast-enhanced ultrasound and fine needle aspiration biopsy

作　　者：于晶 梁凯迪 蒋南 曹军英 张筠 Yu Jing;Liang Kaidi;Jiang Nan;Cao Junying;Zhang Yun(Department of Ultrasound Diagnosis,General Hospital of Northern Theater Command,Shenyang 110016,China)

机构地区：[1]北部战区总医院超声诊断科,沈阳110016

出　　处：《中国临床实用医学》2023年第4期31-34,共4页China Clinical Practical Medicine

基　　金：辽宁省科学技术计划项目(2020JH2/10300122);沈阳市科技计划项目(20-205-4-058)。

摘　　要：目的探讨常规超声、超声造影联合细针抽吸活检(FNAB)对甲状腺结节鉴别诊断的效果。方法本研究为病例对照研究, 选取2021年1月至2022年10月在北部战区总医院超声诊断科检查的294例甲状腺结节患者, 每例患者选取1枚结节。男109例, 女185例, 年龄(45.39±8.39)岁, 年龄范围为35~75岁。采用简单随机抽样法将患者随机分为超声造影组、常规超声+FNAB组、常规超声+超声造影+FNAB组, 每组98例。以病理结果作为"金标准", 观察超声造影、常规超声联合FNAB、常规超声及超声造影联合FNAB诊断甲状腺结节良恶性的效果和准确率。结果常规超声+超声造影+FNAB组诊断甲状腺结节良恶性的准确率、灵敏度、特异度[91.8%(90/98)、91.8%(56/61)、91.9%(34/37)]显著高于超声造影组[70.4%(69/98)、69.0%(40/58)、72.5%(29/40)], 差异有统计学意义(P<0.05)。常规超声+超声造影+FNAB组诊断甲状腺结节良恶性的准确率、灵敏度、特异度[91.8%(90/98)、91.8%(56/61)、91.9%(34/37)]显著高于常规超声+FNAB组[75.5%(74/98)、77.4%(48/62)、72.2%(26/36)], 差异有统计学意义(P<0.05)。结论常规超声、超声造影联合FNAB可提高甲状腺结节良恶性的准确率, 值得临床推广运用。Objective To explore the effectiveness of conventional ultrasound(US),contrast-enhanced ultrasound(CEUS),and fine-needle aspiration biopsy(FNAB)in the differential diagnosis of thyroid nodules.Methods This study was a case-control study,a total of 294 patients with thyroid nodules were selected from January 2021 to October 2022 in the department of Ultrasound Diagnosis in General Hospital of Northern Theater Command,and one nodule was selected for each patient,including 109 males and 185 females,aged(45.39±8.39)years old,ranging from 35 to 75 years old.Using a simple random sampling method,patients were divided into CEUS group,US+FNAB group,and US+CEUS+FNAB group,with 98 cases in each group.Using pathological results as the"gold standard",observe the effectiveness and accuracy of CEUS,US combined with FNAB,US,and CEUS combined with FNAB in diagnosing benign and malignant thyroid nodules.Results The accuracy,sensitivity,and specificity of the US+CEUS+FNAB group in diagnosing benign and malignant thyroid nodules[91.8%(90/98),91.8%(56/61),91.9%(34/37)]were significantly higher than those of the CEUS group[70.4%(69/98),69.0%(40/58),72.5%(29/40)],the differences were statistically significant(P<0.05).The accuracy,sensitivity,and specificity of diagnosing benign and malignant thyroid nodules in the US+CEUS+FNAB group[91.8%(90/98),91.8%(56/61),91.9%(34/37)]were significantly higher than those in the US+FNAB group[75.5%(74/98),77.4%(48/62),72.2%(26/36)],the differences were statistically significant(P<0.05).Conclusions The combination of US,CEUS,and FNAB can improve the accuracy of benign and malignant thyroid nodules,and is worthy of clinical promotion and application.

关 键 词：超声造影 细针抽吸活检 甲状腺结节 诊断 

分 类 号：R736.1[医药卫生—肿瘤] R445.1[医药卫生—临床医学]