超声造影和US-FNAB在甲状腺结节良恶性鉴别中的应用  

Application of contrast-enhanced ultrasound and US-FNAB in the differentiation of benign and malignant thyroid nodules

作　　者：谭玉琪 卢丽萍 TAN Yuqi;LU Liping(The Sixth Affiliated Hospital of South China University of Technology,Guangdong,Foshan 528200,China)

机构地区：[1]华南理工大学附属第六医院,广东佛山528200

出　　处：《中国医药科学》2023年第24期34-38,共5页China Medicine And Pharmacy

基　　金：广东省佛山市卫生健康局医学科研课题(20210395)。

摘　　要：甲状腺结节是临床常见疾病。目前已有不少研究证实甲状腺超声造影、超声引导下甲状腺结节细针穿刺活检在甲状腺良恶性结节的鉴别中能进一步提高诊断效能。甲状腺结节超声引导下细针穿刺活检(USFNAB)的准确率高,安全性好,但因取材及判读者经验的高依赖性,结节固有特性等客观因素存在,仍有不同程度出现假阴性的可能,需要探索一项更为精准的引导方案。超声造影对病灶周边组织及病灶内微血管可进行实时的动态、连续观察病灶血管的分布、血流灌注等情况,但良恶性结节表现交叉重叠、背景声像对造影结果的影响,使得超声造影对结节良恶性的诊断价值争议颇多。US-FNAB对术前鉴别良恶性结节具有重要意义,然而,两者单独使用均有不同程度的局限性,而甲状腺超声造影能为甲状腺结节提供更多微血管方面的信息,为了更好地明确甲状腺结节性质,免于过度或延误治疗,需要探索一项更为精准的引导方案。超声造影被认为是细针穿刺活检的一种有价值的补充方法,而超声造影如何能更好补充US-FNAB可能是一个新的研究方向。Thyroid nodules are a type of common clinical disease.Currently,many studies have confirmed that contrast-enhanced ultrasound and ultrasound-guided fine-needle aspiration biopsy of thyroid nodules can further improve diagnostic efficiency in the differentiation of benign and malignant thyroid nodules.Ultrasound-guided fine-needle aspiration biopsy(US-FNAB)of thyroid nodules has high accuracy and good safety.However,due to the high dependence on sampling and reader experience,inherent characteristics of nodules and other objective factors,there is still a possibility of false negatives to varying degrees.Therefore,a more precise guidance plan needs to be explored.Contrast-enhanced ultrasound can provide real-time dynamic and continuous observation on the surrounding tissues of the lesion and microvessels within the lesion,including the distribution and blood flow perfusion of the lesion’s blood vessels.However,the impact of overlapping and background ultrasound on the imaging results has led to controversy over the diagnostic value of contrast-enhanced ultrasound in the diagnosis of benign and malignant nodules.US-FNAB is of great significance for the preoperative differentiation of benign and malignant nodules.However,the two methods mentioned above have varying degrees of limitations when used alone.The contrast-enhanced thyroid ultrasound can provide more microvascular information for thyroid nodules.To better clarify the nature of thyroid nodules and avoid excessive or delayed treatment,it is necessary to explore a more precise guidance plan.Contrast-enhanced ultrasound is considered a valuable complementary method for fineneedle aspiration biopsy,but how contrast-enhanced ultrasound can be better combined with US-FNAB,which may be a new research direction.

关 键 词：甲状腺结节 超声造影 细针穿刺活检 良恶性鉴别 

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]