彩色多普勒超声引导甲状腺结节细针穿刺诊断应用及质量控制价值研究

Application of color Doppler ultrasound guided fine needle aspiration biopsy of thyroid nodules and its quality control value

目的探讨彩色多普勒超声引导甲状腺结节细针穿刺的临床应用,分析临床诊断价值及质量控制情况。方法选取2017年1~11月期间于本院就诊并接受治疗的甲状腺结节患者60例,采取回顾性分析,总结彩色多普勒超声引导下甲状腺结节细针穿刺以及超声诊断结果,包括特异度、灵敏度、准确率等,并与手术病理及随访结果比较。结果行彩色多普勒超声引导甲状腺结节细针穿刺的60例患者中,阳性20例,阴性40例。甲状腺结节超声诊断与细针穿刺细胞学表现,超声诊断灵敏度为75.00%(15/20);特异度为80.00%(32/40);准确率为78.30%(47/60);假阳性率为20.00%(8/40)。细针穿刺诊断的灵敏度为90.00%(18/20);特异度为95.00%(38/40);准确率为93.30%(56/60)。结论在超声引导下,细针穿刺能够正确选择甲状腺结节目标,在超声引导下行细针穿刺活检能够取得显著效果,对穿刺过程予以质量控制,可以提高技术水平,在临床具有推广与应用价值。

Objective To explore the clinical application of fine needle puncture in thyroid nodules guided by color Doppler ultrasound,and to analyze the value of clinical diagnosis and quality control.Methods Sixty patients with thyroid nodules who were treated in our hospital from January to November 2017 were selected and analyzed retrospectively.The results of fine needle puncture and ultrasound diagnosis of thyroid nodules under the guidance of color Doppler ultrasound were summarized,including specificity,sensitivity and accuracy,and is compared with surgical pathology and follow-up results.Results Color Doppler ultrasound guided fine needle puncture of thyroid nodule was performed in 60 patients,of whom 20 were positive and 40 were negative.The ultrasonic diagnosis of thyroid nodules was consistent with fine needle aspiration cytology,the sensitivity of ultrasound diagnosis was 75%(15/20),the specificity was 80%(32/40),the accuracy rate was 78.3%(47/60),and the false positive rate was 20%(8/40).The sensitivity of fine needle aspiration diagnosis was 90%(18/20),the specificity was 95%(38/40),and the accuracy rate was 93.3%(56/60).Conclusion Under the guidance of ultrasound,the fine needle puncture can correctly select the thyroid nodule target,can achieve remarkable effect in the ultrasound-guided downlink fine needle puncture biopsy,quality control of the puncture process,can improve the technical level,and has popularization and application value in clinic.