超声引导下甲状腺细针穿刺诊断可疑恶性钙化灶TI-RADS 4级1 cm以内小结节的检出率及影响因素  

The Detection Rate and Influencing Factors of TI-RADS Grade 4 Nodules≤1 cm in the Diagnosis of Suspected Malignant Calcifications via Ultrasound-Guided Fine Needle Aspiration

作　　者：王栋 WANG Dong(Department of Thyroid Surgery,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou Henan 450000)

机构地区：[1]郑州大学附属郑州中心医院甲状腺外科,河南郑州450000

出　　处：《医学临床研究》2025年第2期235-238,242,共5页Journal of Clinical Research

摘　　要：【目的】探讨超声引导下甲状腺细针穿刺诊断可疑恶性钙化灶甲状腺影像报告与数据系统(TI-RADS)4级1 cm以内小结节的检出率及影响因素。【方法】前瞻性选取2020年1月至2023年12月本院收治的213例TI-RADS 4级1 cm以内小结节患者为研究对象,均行超声引导下甲状腺细针穿刺诊断,将术后组织病理学检查结果作为金标准。分析超声引导下甲状腺细针穿刺对TI-RADS 4级1 cm以内小结节的诊断价值,分析超声引导下甲状腺细针穿刺诊断TI-RADS 4级1 cm以内小结节准确度的影响因素。【结果】术后病理诊断显示:184例为恶性结节,29例为良性结节。超声引导下甲状腺细针穿刺术诊断TI-RADS 4级1 cm以内小结节诊断准确192例,21例诊断被低估。超声引导下甲状腺细针穿刺诊断TI-RADS 4级1 cm以内小结节良恶性的灵敏度、特异度、准确度分别为88.59%、100.00%、90.14%。Logistic回归分析显示:结节最大直径、结节成分、钙化情况、血供情况是超声引导下甲状腺细针穿刺诊断TI-RADS 4级1 cm以内小结节准确度的影响因素(P<0.05)。【结论】可疑恶性钙化灶TI-RADS 4级1 cm以内小结节为恶性结节风险较高,结节最大直径、结节成分、钙化情况、血供情况是超声引导下甲状腺细针穿刺诊断TI-RADS 4级1 cm以内小结节良恶性准确度的影响因素。【Objective】To investigate the detection rate of grade 4 nodules within 1 cm and the influencing factors in the diagnosis of suspected malignant calcification by ultrason-guided thyroid fine needle puncture in the Thyroid Imaging Reporting and Data System(TI-RADS).【Methods】A total of 213 cases of TI-RADS grade 4 patients with small nodules less than 1 cm were prospectively selected in our hospital from January 2020 to December 2023.All of them underwent ultrasound-guided thyroid fine needle puncture diagnosis,and the postoperative histopathological examination results were used as the gold standard.The diagnostic value of ultrasound-guided thyroid fine needle puncture in the small nodules within 1 cm of grade 4 TI-RADS was analyzed,and the influencing factors of the accuracy of ultrasound-guided thyroid fine needle puncture in diagnosing the small nodules within 1 cm of grade 4 TI-RADS were analyzed.【Results】Postoperative pathological diagnosis showed that 184 cases were malignant nodules and 29 cases were benign nodules.Ultrasound-guided thyroid fine needle puncture was used to diagnose grade 4 small nodules within 1 cm of TI-RADS accurately in 192 cases,and under-diagnosed in 21 cases.The sensitivity,specificity and accuracy of ultrasus-guided thyroid fine needle puncture in diagnosing the benign and malignant nodules within 1 cm of grade 4 TI-RADS were 88.59%,100.00%and 90.14%,respectively.Logistic regression analysis showed that the maximum nodule diameter,nodule composition,calcification,and blood supply were the influencing factors for the accuracy of ultrasound-guided thyroid fine needle puncture in diagnosing small nodules within 1 cm of grade 4 TI-RADS(P<0.05).【Conclusion】The risk of malignant nodules within 1 cm of grade 4 TI-RADS with suspected malignant calcification is higher.The maximum diameter of nodules,nodule composition,calcification and blood supply are the factors influencing the accuracy of diagnosing the benign and malignant nodules within 1 cm of grade 4 TI-RADS with ultraso

关 键 词：甲状腺结节 超声检查 活组织检查 细针 诊断 鉴别 影响因素分析 

分 类 号：R736.1[医药卫生—肿瘤]