摘要
目的探讨超声引导下细针穿刺活检(US—FNAB)对甲状腺超声影像报告和数据系统(TI—RADS)4a类且直径≤10mm甲状腺结节的诊断价值。方法回顾性分析接受US—FNAB检查的甲状腺结节患者的超声特征,根据TI-RADS评估每个结节的恶性特征并进行分类,将其中TI—RADS4a类且直径≤10mm365例患者的甲状腺结节均行US.FNAB检查,并根据超声测量结节最大径分为〈5mm组和5.10mm组.对细胞学诊断结果与病理结果进行对照分析。结果365例TI-RADS4a类结节中,细胞学诊断恶性68例,可疑恶性81例,良性193例,不满意6例,不确定17例;经术后病理或临床随访,恶性153例,良性212例,US—FNAB细胞学结果和实际病理结果无明显差别(P〉0.05)。5~10mm组结节的细胞学阳性率和实际恶性率均大于〈5mm组(P〈0.05)。US-FNAB细胞学诊断TI—RADS4a类甲状腺结节的灵敏度、特异度、阳性预测值、阴性预测值及准确率分别为92.2%、96.2%、94.6%、94.4%和94.5%。结论US-FNAB检查对TI-RADS4a类甲状腺结节有较高的诊断价值。能有效提高术前诊断的准确性。
Objective To explore the diagnostic value of ultrasound guided fine needle aspiration biopsy (US-FNAB) for thyroid imaging reported and data system (TI-RADS) 4 class - 10 mm thyroid nodules. Methods The preoperative ultrasound features of patients with thyroid nodule who received US- FNAB examination were retrospectively analyzed, the malignant risk of each nodule was evaluated and classified according to TI-RADS. TI-RADS 4a class thyroid nodules and diameter ≤ 10 mm of 365 patients were classified as suspicious nodules and received US-FNAB examination. The nodules were classified as 〈 5 mm and 5 - 10 mm groups. The results of cytologic diagnosis were compared with the pathological diagnosis,and the differences for nodules with different size were analyzed. Results Among 365 TI-RADS 4 class thyroid nodules diagnosed by the cytology, 68 nodules were malignant; 81 nodules were suspicious of malignancy; 193 nodules were benign; 6 nodules were unsatisfactory; and 17 nodules were undetermined. According to postoperative pathology or follow-ups, 153 nodules were malignant and 212 nodules were benign. The difference between US-FNAB results and pathology was not significant ( P 〉 0. 05 ). Cytologic positive rate and actually malignant rate of the nodules in 5 - 10 mm group were higher than 〈5 mm groups ( P 〈 0. 05 ). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of US-FNAB cytological diagnosis of TI-RADS 4 class thyroid nodule were 92. 2% , 96. 2%, 94. 6% ,94.4% and 94. 5% ,respectively. Corldusion US-FNAB examination is valuable for the diagnosis of TI-RADS 4a class thyroid nodules and improves the preoperative diagnosis.
出处
《中华普通外科杂志》
CSCD
北大核心
2016年第8期673-676,共4页
Chinese Journal of General Surgery
基金
国家自然科学基金青年项目(81401412)