超声造影、MSCT及细针穿刺在甲状腺结节良恶性病变诊断中的应用

Application of Contrast-enhanced Ultrasonography, MSCT and Fine Needle Aspiration Cytology in the Diagnosis of Benign and Malignant Thyroid Nodules

目的分析超声造影(CEUS)、MSCT及细针穿刺(FNAC)在甲状腺结节良恶性病变诊断中的应用价值。方法选取2016年7月至2017年11月我院收治的甲状腺病变患者90例(95个结节),其中病理检查证实为良性结节40个,恶性结节55个,均采用CEUS、MSCT、FNAC检查,分析三种检查方法下各影像特征,并评估CEUS、MSCT、FNAC的诊断效能。结果 CEUS、MSCT下甲状腺良恶性结节均有其特征性影像学表现;FNAC诊断甲状腺结节恶性病变的特异度、准确度、阳性预测值、阴性预测值高于CEUS、MSCT,而CEUS、MSCT、FNAC三者联合检测诊断甲状腺结节恶性病变的灵敏度、特异度、准确度、阳性预测值、阴性预测值高于单项检测(P<0.05)。结论 CEUS、MSCT、FNAC在甲状腺良恶性病变中有较高诊断价值,尤其是FNAC有较高的特异度、准确度,三者联合检测有助于提高诊断效能,值得在临床推广应用。

Objective To analyze the value of contrast-enhanced ultrasonography（CEUS）, MSCT and fine needle aspiration cytology（FNAC） in the diagnosis of benign and malignant thyroid nodules. Methods 90 patients（95 nodules） with thyroid disease who were admitted to the hospital from July 2016 to November 2017 were studied. Among them, 40 benign nodules and 55 malignant nodules were confirmed by pathological examination. All of them were examined by CEUS, MSCT and FNAC. The imaging features of the three methods were analyzed, and the diagnostic efficiencies of CEUS, MSCT and FNAC were evaluated. Results Imaging findings of both CEUS and MSCT for benign thyroid nodules were characteristic. The specificity, accuracy, positive predictive value and negative predictive value of FNAC for the diagnosis of thyroid nodules were higher than those of CEUS or MSCT. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of combined detection of CEUS, MSCT and FNAC were higher than those of single detection（P〈0.05）. Conclusion CEUS, MSCT and FNAC are of high diagnostic value for benign and malignant thyroid lesions. The specificity and accuracy of FNAC are high. The combined detection of the three is helpful to improve the diagnostic efficiency.