超声引导下细针穿刺活检联合超声造影检查对甲状腺良恶性结节的鉴别诊断价值  

Value of ultrasound-guided fine-needle aspiration biopsy combined with contrastenhanced ultrasound in differential diagnosis of benign and malignant thyroid nodules

作　　者：陈丽雯 刘志兴[2] CHEN Liwen;LIU Zhixing(Department of Ultrasonic Medicine,Ganjiang New Area Hospital of the First Affiliated Hospital of Nanchang University(Ganjiang New Area People’s Hospital),Nanchang 330000,Jiangxi,China;Department of Ultrasonic Medicine,the First Affiliated Hospital of Nanchang University,Nanchang 330000,Jiangxi,China)

机构地区：[1]南昌大学第一附属医院赣江新区医院(赣江新区人民医院)超声医学科,南昌330000 [2]南昌大学第一附属医院超声医学科,南昌330000

出　　处：《癌症进展》2025年第1期83-86,共4页Oncology Progress

摘　　要：目的探讨超声引导下细针穿刺活检(US-FNAB)联合超声造影检查对甲状腺良恶性结节的鉴别诊断价值。方法选取82例甲状腺结节患者,均行超声造影和US-FNAB检查,以手术病理检查结果为金标准,分析超声造影、US-FNAB单独及联合检查对甲状腺恶性结节的诊断价值。采用Kappa检验分析超声造影、US-FNAB单独及联合检查诊断甲状腺良恶性结节的结果与病理检查结果的一致性。比较甲状腺恶性结节和良性结节患者的超声影像学特征。结果经手术病理检查,82例患者中,甲状腺恶性结节40例,甲状腺良性结节42例。USFNAB联合超声造影检查诊断甲状腺恶性结节的灵敏度、特异度、准确度、阳性预测值、阴性预测值分别为97.50%、100%、98.78%、100%、97.67%,均高于二者单独检查。US-FNAB联合超声造影检查诊断甲状腺良恶性结节的结果与病理检查结果的一致性高于二者单独检查。甲状腺恶性结节患者中边界不清晰、形态不规则、纵横比≥1、微钙化、增强密度不均匀、等及低增强比例均明显高于甲状腺良性结节患者,差异均有统计学意义(P﹤0.01)。结论US-FNAB联合超声造影检查对甲状腺良恶性结节具有较高的鉴别诊断价值,有利于早期开展精准治疗,从而改善患者预后。Objective To investigate the value of ultrasound-guided fine-needle aspiration biopsy(US-FNAB)combined with contrast-enhanced ultrasound in differential diagnosis of benign and malignant thyroid nodules.Method A total of 82 patients with thyroid nodules were selected and underwent contrast-enhanced ultrasound and US-FNAB examinations.Using the results of surgical pathological examination as the gold standard,the value of contrast-enhanced ultrasound and US-FNAB single and combined examination in the diagnosis of malignant thyroid nodules were analyzed.Kappa test was used to analyze the consistency between the results of contrast-enhanced ultrasound and US-FNAB single and combined examination in the diagnosis of benign and malignant thyroid nodules and the results of pathological examination.The ultrasound imaging features of malignant thyroid nodules and benign thyroid nodules were compared.Result Pathological examination results showed that among 82 patients,40 patients had malignant thyroid nodules and 42 patients had benign thyroid nodules.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of US-FNAB combined contrast-enhanced ultrasound in the diagnosis of malignant thyroid nodules were 97.50%,100%,98.78%,100% and 97.67%,respectively,which were higher than those of single examination.The results of USFNAB combined with contrast-enhanced ultrasound in the diagnosis of benign and malignant thyroid nodules were more consistent with the results of pathological examination than those of single examination.The proportion of unclear boundary,irregular shape,aspect ratio≥1,micro-calcification,uneven enhancement density,equal and low enhancement in patients with malignant thyroid nodules were significantly higher than those in patients with benign thyroid nodules,and the differences were statistically significant(P<0.01).Conclusion US-FNAB combined with contrast-enhanced ultrasound has a high value in differential diagnosis of benign and malignant thyroid nodules,which is co

关 键 词：甲状腺结节 超声引导下细针穿刺活检 超声造影 鉴别诊断 

分 类 号：R736.1[医药卫生—肿瘤]